HomeMy WebLinkAboutBuilding Permit 11. 0964 J
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ir PRifr CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
.Alc TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
tX AND UTILITY CONNECTION PERMIT
U y 1 c,
',NNE soli- I. White File PERMIT NO. r
3 Pink City l (J�( 4—
_
3 Yellow Applicant l V�
(Aease type or print and sign at bottom)
DDRESS) ZONING(office use)
/7L/// ,)t1 &.� - //r. sat. f kyoeLaKe , 3 7Z
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
i4 " - �/� /.1 /1,00/Z -i //C"(/ d //� (Phone) el S 2 /.303 -S3 2 Z
(Address) /7`7// ....... /.5,.a.--77 .,, / PRfOi /are .5313 /72_
BUILDER
(Company Name) 666-Axe /K (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction 'DeckRe-Roofing ORe-Siding ['Lower Level Finish 1:1 Fireplace
['Addition ❑Alter ion ❑Apr
nneectn
CODE: I.R.C. ❑I.B.C. I=1 Misc.
Type of construction: I II III IV V AB PROJECT COST/VALUE $
Occupancy Group: ABE F HI M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certify hat 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-mention•+,��operty and tha • structio 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 .,"t ' rm . just cause Fui er ore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X .ri ti _ AO •" a 2-__ l I
Contractor's License No. Da e
Permit Valuation 7000 Park Support Fee # $
Permit Fee $ i .� Zs SAC # $
Plan Check Fee $ 9 5.i 1 Water Meter Size 5/8"; 1"; \ $
State Surcharge $ 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 $ 4' 4
This A i io ecomes Your Building:ern*Wh A oved Paideceipt No. f
Datelc,
tic( By
" f
uilding Official el u
Date
This is toe at )•request in tilt.above application and accompanying doc ent s in accordance with the City Zoning Ordinance and may proceed as requested. This document
when sig/ t e r Planner constitutes a temporary Certificate of Zoning mph cc and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
clued
. ing Di for �r 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
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS4l1 , tom- , •
t� �� (
TYPE OF WORK
USE OF BUILDING ,a
PERMIT NO. DATE ISSUED 12--1
BUILDER / tL PHONE # asp-.�o�_SSaz
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
FINAL
FOR ALL INSPECTIONS (952) 447-9850