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HomeMy WebLinkAboutBuilding Permit 15. 0949 > _ 0 _ . n O DQO ❑ -o 0 > E0 k 0 ° 0 2 § 41 2c. 00 z m k SG m � � � XI Xmm m k � § § ¢ - � \ * r 0q › Q. z B ® 2 0 zo k § u) 0 z 2 § ■ \ d oil 2 • K • 0 7E CZ za - mm % 0 F z 7 m. i x r �' - / -I 0 z . (/),, 200 • 000000 z M mM /� � r � t � r § ° 4 _ . m = . m 00 - 0) t \ M - --1 > 000 � 0 2 -4 m ` ~ n 0 00o0 § p 0 - 0 z zXm z r k 2 § m � \ § P 0 / I 73 m/ n 1 _ § 00000E1 o q z 7 > 22 § q q � mmso % 0 0 E -17 "0IIxl � \ 0 § 00 § � 0 j � _ _ � F k kr 0 r CPRi�� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd y TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �`� `S' X AND UTILITY CONNECTION PERMIT �j NEsOlt. I. White File 2. Pink City PERMIT NO. /5 qy 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS I (r ? I ,�^A ee woof KiZONING(office use) Sk& e(' ie, 1Al cc 7i /C/ LEGAL DESCRIPTION(office use only) LOT77 BLOCK ADDITION '2En/tiere_ geV6,6. PID e_5'.44-a 024.6 OWNER(Name) Ancixe‘A) 7:I'1ic,r1 s c (Phone) (&1. ( 3( 01 ‘ 1 (Address) BUILDER (Company Name) (Phone) (Contact Name) (Phone) (Address) TYPE OF WORK ❑New Construction ❑Deck ['Porch ❑Re-Roofing ❑Re-Siding ['Lower Level Finish ❑Fireplace ❑Addition ['Alteration ['Utility Connection A� �� _ CODE: .R.C. ❑I.B.C. 'Misc. /Ve�ik'Cl/C7 5776GC�1�L�•epi /U " /5' Type of Co struction: I II III IV V A B 4� PROJECT COST/VALUE/ $ Occupancy Group: A B E F H I M R SU (excluding land) Division: 1 2 3 4 5 I hereby certify that I h. e 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-mentio d pro.„ 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.joke th rmit for just cause Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. aoic- Signature Contractor's License No. Date Permit Valuation 3 o ©O , 00 Park Support Fee # $ Permit Fee $ C e , 2.5 SAC # $ Plan Check Fee $ 57. %1 j2 Water Meter Size 5/8"; 1"; $ State Surcharge $ l—cC Pressure Reducer $ Penalty $ Sewer/Water Connection Fee # $ Plumbing Permit Fee $ Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer&Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL DUE 01109 e,?,„)..is-- / Ic...-7._ /7 This App ',tion 'ecomes Your Building Permit When Approv•I Paid 4'7/l Receipt No. ,/ Date �- �� By R � 7,, r (� Cut _ Date This is to certify t.,,/ her rarest in the above application and accompanying document s in aces.ance with the City Zoning Ordinance and may proceed as requested. This document when signed by,il'ty i.. - .stitutes a temporary Certificate of Zoning compf cc and ows construction to commence. Before occupancy,a Certificate of Occupancy must be issued. i;(illA 1111 — /.5. Plannin _ 1. • Special Conditions,if any 24 hour notice for a I inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street Prior Lake,MN 55372 DEPAR ENT OF PRIOR LAKE AND BUILDING INSPECTIONS IING INSPECTION RECORD SITE ADDRESS '�j��C�W� WAY �RC��j TYPE OF WORK USE OF BUILDING PERMIT NO. is. q4q DAT/ISSUED a� ie. is' BUILDER Attatiet ��M�� PHONE # `12,, 434. OM INSPECTOR DATE L� F M�1lG I PLACE NO CONCRE E UNTIL ABOVE HAS BEEN SIGNED 11.11111. 1 I FINAL I I I FOR ALL INSPECTIONS (952) 447-9850