HomeMy WebLinkAboutBuilding Permit 14. 1250 ir
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of PRlp� CITY OF PRIOR LAKE BUILDING PERMIT, itDate
Rec d
TEMPRCETIFICATEFZNINGCMPLIANCEI ��
ti,
4%kly Est:01lik
; I. while File PERMIT NO. ' /(
2. Pink City f /3 50
3 Yellow Applicant r l��
(((//
se type or print and sign at bottom)
DDRESS ZONING(office use)
I 1 S ,ISQodc.,4fie ? 121SL2l
LEGAL DESCRIPTION(office use only) ,� ( /,LOTLGl BLOCK ADDITION j: I (ds fV 01 PID &-5 Lio • U01(-00
OWNER '
(Name) - it r i VVl SO—VI ....
O—VIT (Phone) / 52-1-13-4/-4727
(Address) �L 15 vu,, SAv�L / I/�1, ,'? — L4- S 537
BUILDER ((...a.„--C-(Company Name) k 4� ,A--,A ry(Phone) [/Q-3-3(5-t5145-
(Contact Name) M.\�Z� 1 '3 (Phone) 2-k�--42_ ( ps-
(Address) 1 0 5 5-l/y' e--,,, /�q1s- „, i-4, '2.40/ � ",,o ✓, l,Yli SS 36, f
TYPE OF WORK ❑New Construction ❑Deck ❑Porch , Roofing [Me-Siding ['Lower Level Finish ❑Fireplace
CODE: ❑I.R.C.
❑Addition.C. ❑Alteration ['Utility Connection
41peu
1:1 Misc.
e of Construction: I II III IV V A B ,r9
'vision: 1 2 3 4 5 pancy Group: A B E F H I M R S U PROJECT COST/VALUE $ /7C/E'
(excluding land)
iv
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 ca ft
t permit fo t cause. Fur ermore,I hereby agree that the city official ora designee may enter upon the property to perform needed t speedo s.
X O�"'fit BC-!ap f q-7 // ‘ /�
ignature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ y 1 i 7c SAC # $
Plan Check Fee $ r o� Water Meter Size 5/8"; 1"; $
`
State Surcharge $ i �-' 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 $ 1 1
This Application Becomes Your Building Permit When Approved Paid "7 T 7C-
Receipt No. —7 Z.1,47-1
Date `/.a (.47• / / By iii-s-ki/
Building Official Date
111 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
m 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.11 ,
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