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HomeMy WebLinkAboutBuilding Permit 15. 1227 I (c.:! cc') C) 000000 0 zn ,95 n n O ■ rnn '1 0 m � k / k 0 0 0 ° Er /6kd 73 l �. rri r o 2 ■ Z _1 §> Q P 0m k R k » § cn 0 z 0 §xi q its q S 0 o 2 z 0 , mm n > 0 % f r 0 N 0 x x N Cl x 2 § § 000000 s,. m x m mm illmm PI * ■ � \ ° -nc * mc e23 �§ ft f m m0C07 § :1 § > 0_ § § 0 § 5j ° - g 2 zcc � r § 2 § § it -0 "0 P k § / X m c §§ li § . 40000 (1 o_ § e -oep-o �c§ ` Q ) r „ z 0 §\ �>mk73kb § R th m -4r 2 - - m -4r B V of PRtf0R CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT (0.i( 4rikNEso.o• I. White File PERMIT NO. 2. Pink City S�7 3 Yellow Applicant S. V (Please type or print and sign at bottom) ADDRESS ZfNG(office use) 5 la.k Flt,s�, Qo1M-- RAS. se. PeLoc iI 'SA LEGAL �DESCRIPTION(office use only) / ,, S�/ LOT// -/ BLOCK ( ADDITION �4 -42/ r L-4- PID Z (O5 D,q O O((NaWNER )cL)1 �rCni4 t (RVT'I g(-op —��� (Phone) 50-7- --II©0 (Address) (Company Name) NVY1Let4r S- aod---Itn (Phone) (q 52) n5-Li 8- (Contact Name) o hn (Phone) SG/Yv%2, (Address) 35 b q Cl'klr• u 011>v4 Ik, leh Y'), 53- --i TYPE OF WORK 0 New Construction ❑Deck ❑Porch Kite-Roofing ❑Re-Siding ❑Lower Level Finish 0 Fireplace ❑Addition ❑Alteration ❑tJtility Connection CODE: ❑LR.C. ❑LB.C. 0 Misc. Type of Construction: I II III IV V A B PROJECT COST/VALUE $ ill i(4/ q ' Occupancy Group: A B E F H I M R S U (excluding land) Division: 1 2 3 4 5 I herebycertify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the above- nttoned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building offic' ccann�revoke ethis permit for just cause. Furthermore,I hereby agree that the city officialQSC a designee may entererupon the property to perform needed inspect ms. X LC/rWAC/ kJ l.• .Y 11 V J 'q 10 /7!/r� Signature Contractor's License No. Date Permit Valuation / Park Support Fee # $ Permit Fee $ 1 J SAC # $ Plan Check Fee $ Water Meter Size 5/8"; 1"; $ iV a State Surcharge $ 7\ 0 ressure Reducer $ Penalty $ Sewer/Water Connection Fee # $ PIumbing Permit Fee $ Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer&Water Permit Fee $ Other $ •`r' �� Gas Fireplace Permit Fee $ TOTAL DUE $ This Application Becomes Your Building Permit When Approved Paid '4/ c''7 c Receipt No. 3© /7 Date ' By ".- r-'" Building Official Date This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be issued Planning Director Date Special Conditions,if any 24 hour notice for all inspections(952)447-9850 4646 Dakota Street Prior Lake,MN 55372