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HomeMy WebLinkAboutBuilding Permit 15. 1390 E 0 ON74 n 000000 0 > z2 n n k 0 � K 2 �J$ � � � § § �4 r R 7 3 � © § m � m2 § j § 2 m 0 - ca �0 0 n © ■ 4%. 1.0 7 § k 0 � % nm m \ r Z m r- 0 % o z7J Z q 00 0 - - 000000 m m m m 0 -4 Z § § ��2t�� .. 2 K ? m & § ■ � M § m o co m § q > o o C k m • A 0Z r o 73 -1 p o 0 ■ .(0) > cc z 2 z # � � � P 0 / ■ 0 X / @ C 0 m XO ❑ OOO U"\- • 5 o711iin J 0 v ® camm20 r: -13 M \ m00 0 § in XIm E ■ � z ■ --I 1- o (04 CITY OFPRIORLAKE BUILDINGPERMIT, Date Rec'd TEMPRCETIFICTEFZINGCMPLIANCE 6l f IE. 7AND UTILITY CONNECTION PERMIT lelI White FilePERMIT NO. 155- 0f 0 2 pink City ` 3 Yellow Applicant ase type or print and sign at bottom) (04,(2'2"0J F. ZONING(office use) DDRESS S LEGAL DESCRIPTION(office use only) 25--©/1 _D LOT/ BLOC ADDITION 0��� 1/ pID OWNER 2 Qo 7 -2. �� gi-'i 7 (Phone)0 5� 4/e,4 - 4-/ 7 c (Address) BUILDER l / J / '7 C S /•-• (Company Name) `C Wit; T� C. ' . Ca c.,`C t� LLP e (Phone) c� — C� (Contact Name) f�`,^^ l '" '�" (Phone) Add ca v y ( " K,s e w -'.1 Af" 5.--VOC a (Address) e-33 � ��' / 1 TYPE OF WORK ❑New Construction ['Deck ❑Porch Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑Fireplace CODE: ❑LR.C. ❑LAdditionBC. ❑Alteration ['Utility Connection 410 ,.. El Misc. . e of Construction: I II III IV V A B PROJECT COST/VALUE $ q o, d pancy Group: A B E F H I M R S U (excluding land) v ❑ision: 1 2 3 4 5 I hereby certify that I have furnished informati.. . s a.plication 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-mentioned8rapctty nd that al . ruction..' sr-inform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official can revoke this permit for tse. F ' ' ore,I hereby agree that the city offici ora designee may enter upon the property to perform needed insg+tions. 43 --X "� ,� ignature Contractor's License No. DateI Permit Valuation Park Support Fee # $ Permit Fee $ -iq' ZSR SAC # $ Plan Check Fee $ . Water Meter Size 5/8"; 1"; $ State Surcharge $ 1r w 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 I $ TOTAL DUE —T- -/c- 1 This Application Becomes Your Building Permit When Approved Paid 1 51 CC Receipt No. ) O S I Date 1 • 1a : lc By 5/(MA Building Official Date 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 signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certi icate of Occupancy must be red Planning Director Date Special Conditions,if any 24 hour notice for all inspections(952)447-9850 4646 Dakota Street Prior Lake,MN 55372