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HomeMy WebLinkAboutBuilding Permit 12. 0671 q 000000 v 0 a zn J � � O ■ � ■� �� 0 7 § 2-c / f � f A - 99�z 2 0 22 ; r ® 0 ■ 2 $ "4 Qq© ' z / 10 g \ 7 § 2 k 73 s \ Z § m tn 71 0 r % f �m C — 1. 000000 Z °m mM gc17CAgE § 15 o 2 § § X� § mm _ -0 p co K ? m zzlxae ■ Z ') m § \ § 2 r2\2 % § W 2 q 00 ir > §c p In % 9 K co 2 ■ 0 t § m , )3 \ 0 000000 1 o ■ m i� n § 3 k R. > 0 K �§ �© 2 A • ����§ J % Z - %.00E � � � E �i 0 (v.- PAR; CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd ,,, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE z AND UTILITY CONNECTION PERMIT6.. ZZ • /7-- U if 1 4 tri Mti'NEso'P I. White File 2. Pink City PERMIT NO./7. 6 ,7//1 3 Yellow Applicant t. (Please type or print and sign at bottom) ADDRESS ZONING(office use) / 7/ 1- 3 csUN/e./ se /4/ t/5e,, / ./.5.0 LEGAL DESCRIPTION(office use only) LOTZ7BLOCK 3 ADDITION (5(//17.56 7— /-#,(,,,S PID 25. 171. D4ic(,. d OWNERI (Name) JA S e r /30R.n1 HORST— ÷— Li SAtv i3 eg02"1aIT- 93`-"t.-(Phone) 77 y-35-oz_ (Address) / 7/V3 S`ci.,,)21 se /.4 Y v S t„l ''2t a 2 ( ,te.E , M N S53.72 BUILDER (Company Name) (Phone) (Contact Name) (Phone) (Address) TYPE OF WORK El New ConstructionDeck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑Fireplace ElAddition ❑Alter ion ❑Utility Connection CODE: .R.C. DI.B.C. ❑Misc. PROJECT COST/VALUE $ Type of onstruction: I II III IV V A B Occup y Group: ABE F HI MR SU Division: 1 2 3 4 5 (excluding land) I hereby certify that I have burnished 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 er r just cause Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. Signature Contractor's License No. Date Permit Valuation 3 06C,•. 0 0 Park Support Fee # $ ort� $ Permit Fee # $ Com ' SAC Plan Check Fee $ �.- 7. 36, Water Meter Size 5/8"; 1"; $ State Surcharge $ /- -S7) 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 $ /4-7, // This A��,, . BecomesXour Building Permit When ppro •d Paid ! #7 if. ceipt No. 6& Z- �T Date lam, 2 L. 1Z2 .. '.hi& i z_ y Bu(ding 01 Icia D e This is to • tify t the request in the above application and accompanying.acumen is in accordance with the City Zoning Ordinance and may proceed as requested. This document when si. . by City Planntn:constitutes a temporary Certificate of Zoni ,compli nee and allows construction to commence. Before occupancy,a Certificate of Occupancy must be slued l 'I mg 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 DEPA TMENT PRIOR LAKE BUILDRNG A D�INSPECTION INSPECTION RECORD SITE ADDRESS gig sumwSE WE. TYPE OF WORK USE OF BUILDING LES AA. PERMIT NO. IL , G I DATE ISSUED G. ZZ. IZ. BUILDER SO�/V�its-ra PHONE #ift 94dZ NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT � CfOR DATE PLACE I PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED komess FINAL FOR ALL INSPECTIONS (952) 447-9850