HomeMy WebLinkAboutBuilding Permit 15. 1404 5 c _ n 000000 13 0 a E0
n n 0 0 0 . _ � 0 §zK � oo z & z �4
k r m m I� i � � k � ��% t , 2 csogi P o■
KS +4 a , m 0 0 2 8
E. ■�� X ] | .. § z �j f ■
k 11 n z § / m m
2 r z 7
2 0 (11
11
• m 0073
%z m nR r 000000
41 X mmm . ■ r ■ * ■ V
* cn ■� no gc2 � 0E
7 2 3 ? m 'F� zz min m 0 " 0
• § >00 13 0x0 q § I m
't 21 0 2 r � OO 0
/ m PP C
r-o -o z m
St0 _
I m
• gi 0 —
k cc ❑ OHO
• E § § , T. 0 f m-
i
R. 0 ►% mm2§
0 !I p
E � � � X Q
41 tti 0 _ §_ OC)
9 m xi .n ■ r 2
0 z m
.4i 0
0./
�F PRrOdP CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE //
AND UTILITY CONNECTION PERMIT ll •j `l S
U
I. White Applicantle //�_ /
a'�HNeS 2 Pink City
PERMIT NO.//L✓�, //., �
3 Yellow
ase type or print and sign at bottom)
DDRESS ZONING(office use)
iSa-1-s V-a:tbaa-s 'Rai l tV � i5b
LEGAL DESCRIPTION(office use only) � � � -
LOT 1 BLOCK ADDITION fe . ��4�� ,,�.��i��✓�-��4 62 PID 25' 0 — eve-60
OWNER(Name) l�(Jl_ C, (. S (Phone) ( 1 P' 7110-110369
� �/`
(Address) 1
BUILDER
(Company Name)%" �y�(i'(lQ
e-n�WC&Q �1J� `'S•� 7 (Phone) 61`O�l/
eg
(Contact Name) �! R V (Phone)
(Address) 1990 CO. ?vii , t G ,' 1A-) 51" ` IWS'e_ �l t'Q l'C, f m N 55113
TYPE OF WORK ❑New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding DLo er Level FinishFi ❑Fir f fl P is
❑Addition ❑Alteration ❑Utility Connection 1 a�j
CODE: ❑I.R.C. ❑I.B.C. ❑ tsc. � � .
e of Construction: I II III IV V A B PROJECT COST/VALUE $ �, 9a(c�
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- tioned property an. t 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 c. revoke this permit'or .st cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
4 13c (097593 . // ua,�
Signature
X Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ /6 SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ ` Pressure Reducer $
Y
Penalt $ v, Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $ 'ej^ r-,' //�
Gas Fireplace Permit Fee $ TOTAL DUE
This Application Becomes Your Building Permit When Approved Paid Ale) 1Receipt No. r
Date Byc--)
w.4,\5
Building Official Date
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
signed by the City Planner constitutes a temporaryCertificate of Zoning compliance and allows construction to commence. Before occupancy,a Cernficate of Occupancy must be
gid.
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