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HomeMy WebLinkAboutBuilding Permit 13. 1263 n O*ccC'oo 0 a En n n 0 ■ -ns -n � -n § § riots?: � § 3 r � E � § m o@ a o r m m m § § ■ F. ■ ■ 8; t � § § cD c o $ 90 � y, n _ o § � § mr K r ‹ ( m � % � k § § % 000000 x q 2 m ;11 � — kci ■ m \ 1 m § ' n k 0 f 0 r> ` c q o 0 ■ m - z 2 7 W % § k 0 ■ m Eno e < 000000 � 202 © > 22 N O § ` § >: C -0 ri555o �� § 0 � � � 4 m -n ■ E § 4q r § of PRio,i , CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / Q Z.7) x AND UTILITY CONNECTION PERMIT C / U . l3' 4:,zyNBso�� I. Whine file PERMIT NO. 2 Pink City / 3 r / Z 3 White File Applicant Yel 63 ase type or print and sign at bottom) ADDRESS ZONING(office use) 3)3�i N\lt,-�,r- \c C- , \U'.) ` .0 YD -c,\< �M1� '65 ., 'Pt LEGAL DESCRIPTION(office use only) / /� LOT BLOCK / ADDITION ./1/..e �/-�n, i7'r / A i �"�S PID a7,5- 333,- 0112-e OWNER (Name) QSg QTC-c,-5\C144,5S (Phone) 96a- 1^'1417-n\a-, (Address) 3a-' —I. .0, A-1a r e.: ItN1i,� 'i V ' 1..0, 7Ni''\tV 55-1 -, 1 BUILDER (Company Name) C--s' -i' rS -* 9--..es--Vtx-c,IA v, (Phone) +V31" 11 SS (Contact Name) -----4C1<-0N-- \--'\T.:r --Va, (Phone) V).,-". L E L1 (Address) 5t \ Qema,(-,-.1c_,.z,... `R:)\\1,._ Vj ci l MIv x`131 TYPE OF WORK 0 New Construction ❑Deck ❑Porch MSe-Roofing ORe-Siding ❑Lower Level Finish 0 Fireplace ❑Addition ❑Alteration ❑Utility Connection i ,u CODE: DI.R.C. ❑I.B.C. 0 Misc. e of Construction: I II III IV V A B PROJECT COST/VALUE $ pancy Group: A B E F H I M R S U (excluding land) vision: 1 2 3 4 5 I hereby certify 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-mentioned 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 official can revoke this permit for Just cause Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. x ---'..--. \ -- \\V5,1 acol3 Signature Contractor's License No. Date Permit Valuation Park Support Fee # $ Permit Fee $ SAC # $ Plan Check Fee $ / rr�,_ c Water Meter Size 5/8"; I"; $ State Surcharge $ 111 11� Pressure Reducer $ Penalty $ 2 r 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 $ le7' 7s SThis Application Becomes Yo BuildingPermit When Approved � iq 73 Receipt No.703 j 5k P o 11 ate / f c g: 3 Bynetrk- Building 0,trial Date / s 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 en 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 .sued Planning Director Date Special Conditions,if any 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street Prior Lake,MN 55372