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HomeMy WebLinkAboutBuilding Permit 15. 1270 5 DON n 00000a -0 o > E n n § § o . 1 Of '11 z m 0 mo » c � c m „ m nq § r R m 0 rn zr � §§ 2 g cn §� 01 r q q 2 $ �o � Q Z- / -1 ■ 0 d 0) ° Z 2 § xi 9 4 § g § Ni Z r > ° �� 0 3 -I m X k 0 0 000000 m r§ X qm 0 ■ ■ \ A0 mr § \c & ƒ A k § mO■ mco 2 §m > oo _ o z m zi a,NI 0 g,' -I g 3 & r140 7i re c § z 7 Z . - -- o m r 0 / A m C) A nr 2 0000 (A V i 0 z ' / R. % § 13 � "© _ �� . m § -i jX00 - 1 m q � � r 2 -4 § 0 aF PR-4- dieCITY OF PRIOR LAKE BUILDING PERMIT, Date Recd ,, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE .�. AND UTILITY CONNECTION PERMIT /0`15---/5--- 2. /�-/� U �IArHEsp'S� I. Pinke Cit PERMIT NO -7.12.-7d llAiry /��/� 3 Yellow Applicant (/ se type or print and sign at bottom) DRESS ZONING(office use) /3—.30 41) ®,fs ,t Se pz_ LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER jam,, _ ,1 -7 (Name) 1`U j a i9'-/�a2 (Phone) ( /z—7 C— "I 31 l (Address) .5%,"Anh' BUILDER (Company Name) A (Phone) (Contact Name) (Phone) (Address) TYPE OF WORK ❑New Construction ['Deck ❑Porch 2Ke-Rooffng ❑Re-Siding ['Lower Level Finish ❑Fireplace CODE: ❑I.R.C. ❑Addition ['Alteration ['Utility Connection rniu ❑I.B.C. 1=I Misc. e of Construction: I II III IV V A B PROJECT COST/VALUE $ ®a panty Group: A B E F H I M R S U (excluding land) ision: 1 2 3 4 5 I hereby certify that I have burnished 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-mentioned property an hat 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 revoke thiIer or just cause Furthermore,I hereby agree that the city official or a designee ay enter upon the property to perform needed ins ections. X 6 Adt e leis-- / - Signature Cont actor's License No. Date Permit Valuation Park Support Fee # $ Permit Fee $ -/"�) SAC # $ Plan Check Fee $ Water Meter Size 5/8"; 1"; $ State Surcharge $ /rj�) Pressure Reducer $ Penalty $ il�.�rr�� Sewer/Water Connection Fee # $ Plumbing Permit Fee $ 7. 4 Water Tower Fee # $ Mechanical Permit Fee $ trBuilder's Deposit $ Sewer&Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL DUE $ /5.--- This Application Becomes Your Building Permit When Approved Paid Receipt No. Date r �j� By Building Official Date 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 Certificate of Occupancy must be O . Planning Director Date Special Conditions,if any 24 hour notice for all inspections(952)447-9850 4646 Dakota Street Prior Lake,MN 55372