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HomeMy WebLinkAboutBuilding Permit 13. 1159 2 0 0 . C) 000000 W 0 > 2 § n g 2 2 0 0 ■ � � � � � o § o �� • » o ■ E mt■Voo z ■ / t moo / 4r �k >/ 0m 10 ■ m k ƒ A Z.,%:; k 0 k o i- -1 \ o ,_ > © �� z / m JP § r § 2 = m k 0 0 ® / z43 ni 2 ill — 0000 ❑ 0 . u-1 0 E -I § § D ■ � ■ > ■ r 0c » 0E b ON 17 . 0 00 -t00 co ■ - n U r\kk fil - �_ \ N r v � 1 ■ m & c 0 c $ 000000 R. > B a � '1C§ — > / ■ m@2QRI c -07, � / R �mm\\ z -„ ■ § o)t z nt 1r o o* PRI04CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd ,,,, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE x AND UTILITY CONNECTION PERMIT U �j 4r4vlvesdst• i White File PERMIT NO. 3 Yellow Applicant /3 r �� � ase type or print and sign at bottom) DDRESSI`'f .:—e-1/17-0//10 % / / ZONING(office use) Z/0 / � 17-0/rte'C! J' /"J Cr Z�'i� //ht. 6:3-3%1- PERMIT DESCRIPTION(office use only) LOT BLOCK ADDITION PIDO5 — 1. pi —1 1—o OWNER / (Name) �! /I ' L.�4I (Phone) ,jj 8- —)5 (Address) W/- 4,— c/a J71 55 A v,..-./-�A jee, ,474) ,5:53 BUILDER (Company Name) Sall" (Phone) (Contact Name) (Phone) (Address) TYPE OF WORK 0 New Construction ❑Deck ❑Porch e-Roofing DRe-Siding ❑Lower Level Finish 0 Fireplace ❑Addition DAlteration DUtility Con coon 41ICODE: DI.R.C. ❑I.B.C. 0 Misc. of Construction: I II III IV V A B PROJECT COST/VALUE $ pancy Group: ABE F HI MR SU (excluding land) vision: 1 2 3 4 5 t 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 .role. 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 r /t¢per,. f r ju• ca10 u7 Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X /�%., Signature Contractor's License No. Date Permit Valuation Park Support Fee # $ Permit Fee $ /4 SAC # $ Plan Check Fee $ Water Meter Size 5/8"; 1"; $ State Surcharge $ 5•C 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 $ 'q, " This Application Becomes Your Building Permit When Approved Paid ( Receipt No. 10/95 d Date 0 /S /3 By 3A-44-..t) Building Official Dat 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 temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be ted 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