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HomeMy WebLinkAboutBuilding Permit 15. 1191 ƒ 00 n 000000 w o > $ C n n a 0 \ 0 0 yr q z(,)0 z m k %4 k § mm / ■ rraZd z 0 -I ki trl t � � r. k�� � 13Z- tp ■ qk . = 0g a $ m n z ' z m m % x, r k , m 4. m 0 73 7 . . z 71 0 0 000000 4/ M m m m k § RE ��R§ § § .0 ? m m § §73M § m 0 ■ E m 9, - ,.coo M � k 0 trl o o 2X2 - c ' 0 R m r §m o m / A 0 o X m § oIP §@ $ DODO .� � . S , oIb1 R. / . §41 z m® © » r - mz Z ■ wr o ic 114/04CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd c TEMPORARYCERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT tv I3o, l�veso't`' 1. White FileIPERMIT NO. 16-71/W I2. Pink City J//] ftype or print and sign at bottom) a Yellow Applicant //(7/ ADDRESS --,01, 1 911 P I eA5Avl S.+ 1,�' ZONING(office use) LEGAL DESCRIPTION(office use only) LOT BLOCK / ADDITION i�lli i 63O On(-0 � � 5 PID S 1 OWNER y, /� l (Name) 1C�r- ( etU 1 �S�` ('� �. (Phone) l" �1'"�. li (Address) BUILDER �f ( 1 1 (Company Name) 11r i- C t i t 3 ' ' `,3 ?Ctl` (Phone) (D�\ 'ICS—- )NPI49 (Contact Name) Vhf (Phone) (o r\- /Ni E 14S-j (Address)bbLk iTh eN5'2r RV Si-, ‘,)crv\ ti-,A) sr \\L1 TYPE OF WORK 0 New Construction ❑Deck ❑Porch 11 , ['Addition DAlteration ❑Re-Roofing f�Ke-Siding ['Lower Level Finish [1 Fireplace ❑Utility Connection DE: ❑I.R.C. ❑I.B.C. 0 Misc. e of Construction: I II III IV V A B panty Group: ABE F HI MR SU PROJECT COST/VALUE $ \kJ\ 6 0 ivision: 1 2 3 4 5 (excluding land) 1 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 1 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 yoke this permit for ju e. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X H C .-3 1110 q- .z. Signature Contractor's License No. te Date Permit Valuation I Park Support Fee # Permit Fee $ SAC Plan Check Fee $ I J Water Meter Size 5/8"; 1"; State Surcharge , 0Pressure 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 ici 1?S This Application Becomes Your Building Permit When Approved Paid 5."/� r S q -7A- l 6 ------Receipt No. goDate 1 By 111 Building Official Date s 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 n 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 issued. Planning Director Date Special Conditions,if any 24 hour notice for all inspections(952)447-9850 4646 Dakota Street Prior Lake.MN 55372