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HomeMy WebLinkAboutBuilding Permit 15. 1403 J w J 73 QC LL Z W ,itl Z ZWWQ )...1° W UU w 0 WWu C7 W o� a0 C 3 y :: W Li) W i Z �Oj 0 J c O `� _ z j IQ E I- C 0 0 W 0000 < ; a j p. = Z ge _ ZZZ ? W ° c) 0 W ODfe016 a 8z O N U d myWZmu ,Az �a23v� a2 X v v z oo❑ o ❑ ❑ J & cc 0 a a LL X :J1 CZ ZQ O W 11.1 uj O U U4 zz gH a - c NUO ce WO Z O p w F- Y2 < 3 ra EZ aOaZ zC -gZ NWW J W V, � z2J ., CI u. VW W O0 ° Qo OWz °OIX gIZ /- p OOO 15 U V % 0 o uu, 3 U U UZ < a 000000 C.) 0 0 0 c 01 PRIps ! ��3 ! !/' /f 7 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd 6-.,,AN c TEMPORARY CERTIFICATE OF ZONING COMPLIANCE `� AND UTILITY CONNECTION PERMIT �,5 T,r j`�'N E 50� • 1.white File PERMIT NO. 3. Pell City 1 //D (Pleasetype orprint and sign3.Yellow Applicant at bottom) ADDRESS /) ZONING(office use) q5 ift QAiv©e)4:7 3(, , egay? AW-k"� LEGAL DERIPTION ffQ/ JAe_, ,� k G lC1 /D �� LO OCK TIO PID , 2,exi—cam' OWNER -,-1 ✓' (Name) D Al r J)i i/✓- JENS-bi (Phone) .q.,-"A) '14-ii.57o� (Address) li 3 a3 ICA t©i2 &oo p 67--- Se" , foto,. � ,411 /� f BUILDER h/ (Company Name)J//V-PG/� c i'/_.X. (Phone) ..5/ 77a ' 7d l f (Contact Name) ( J1 ?�- 1— (Phone) (Address)c cq//–//U CbGcg_ E /1,9, S7-: 1%ui-1 fn ' 5/ ,? TYPE OF WORK 0 New Construction ['Deck ['Porch ❑Re-Roofing ❑Re-Siding DLower Level Finish 0 Fireplace ❑Addition DAlteration ['Utility Connection 4iiirlype ODE:.❑I.R.C. ❑I.B.C. Misc: 11'14 �/ of Construction: I II III IV V A B �D+ D ccupancy Group: ABE F HI MR S U PROJECT COST/VALUE $ I Division: 1 2 3 4 5 (excluding land) 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 revo>,•+' pe ,it for just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X L 147 i/-C—( Signature Contractor's License No. Date Permit Valuation Park Support Fee # $ Permit Fee $. /it i j SAC # $ Plan Check Fee $ [,^r`, Water Meter Size 5/8"; 1"; $ State Surcharge $ t. V 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 $ (� � This Application Becomes Your Building Permit When Approved Paid I"/ i IJ Receipt No. .3 r.-....s. Date i ' ,.-- By M l (‘Building Official Date f is 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 S.E.,Prior Lake,Minnesota 55372