HomeMy WebLinkAboutBuilding Permit 15. 1167 JQ
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of r_ CITY OF PRIOR LAKE BUILDING PERMITDate Rec'd
,� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE b 2 e 45-
AND UTILITY CONNECTION PERMIT ` t!
iNAES011) I. White File PERMIT NO. �elf City /5- /��
/
3 Pink 3 Yellow Applicant r/
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
i 2`f 7 r-4441 &Ww f ,U GJ /e(
LEGAL DESCRIPTION(office use only)
LOT 6 BLOCK Z ADDITION w titi AlN /-S" PID Z.-S-' 37(e.- O/O.O
OWNER..—
(Name) I 4/N4-1 S fm-c..- (Phone)
(Address) / .s----2...q-2 ( 7 c-v 1 Q-cvr/ itil (..,)
BUILDER l 1 -NI /3 '7 2-s 7
(Company Name) Li ct 0`) v `''''Q''''/ 7'r""ll `�-'1� (Phone) 4 f �/L (p
(Contact Name) ( 'i'l - 'C I P15 (Phone)
(Address) WY (/( j oY J 4 f M vJ
TYPE OF WORK ❑New Construction Deck ❑Porch ❑Re-Roofing ❑Re-Siding ['Lower Level Finish 0 Fireplace
['Addition ❑Alteration_ ['Utility Connection
CODE: ❑I.R.C. ❑I.B.C. 0 Misc.
Type of Construction: I II III IV V A B PROJECT COST/VALUE $ /6 0 0 o- t! c
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5 (excluding land)
I hereby certity that ave 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-mentione ro -rty 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
official can r e thi permit for just cause Furt ermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspectio s.
• X / cam-` f 60 3 a.o� 7 2� 2d ic'
Signature Contractor's License No. Date
Permit Valuation 4-000 —. Park Support Fee # $
Permit Fee $ [03 . — SAC # $
Plan Check Fee $ Q)C, !).0 Water Meter Size 5/8"; 1"; $
State Surcharge $ .Z ` Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Otherff $
Gas Fireplace Permit Fee $ TOTAL DUENtAdeo {0.2 sic $ tl. ( _I S
This Applic/�on ecomesYour Building Permit When ppr ed Paid /11 Q-5 Receipt No.
r� Q C , Date ID-Co-05 By
Bu , ie Officio D, e
This is to certify th her test in the abov accompanying docume s is in ccordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by t.• •ty t1 ner constitutes a temporary Certificate of Zoning comp ancc d allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued.
Tanning IPirector Da a Special Conditions,if any
4 hour notice for all inspections(952)447-9850
4646 Dakota Street Prior Lake,MN 55372
PRIOR LAKE AND U�D NG INS EC'TIO S'NG
INSPECTION
RECORD
SITE ADDRESS /52*7 PDX'
//�+IL �.
TYPE OF WORK DECK
USE OF BUILDING
lear
PERMIT NO. � 1167IS: D�ATE�IS'SUED 208.I�
BUILDER OiCWQQD &MN &ORS PHONE # 6/2- . 75/. Ge,
INSPECTORTE
I FOOTING I !�� I JvI>�‘
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
• I FINAL I A I i//gx� I
FOR ALL INSPECTIONS (952) 447-9850
PRIOR LAKE AND B IL'DING INSP C'TIO SNG
INSPECTION
RECORD
SITE ADDRESS /52*7 PO # 7Z /z.. er�
TYPE OF WORK DECK.
USE OF BUILDING kar Rfie,
PERMIT NO. �S ���p DATE ISSUED gzads-
BUILDER
& CH/QOD WOW �► PHONE # 6/Z . 75/, G249,
INSPECTOR DATE
I FOOTING I I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I am* II
FINAL I I I
FOR ALL INSPECTIONS (952) 447-9850