HomeMy WebLinkAboutBuilding Permit 16. 0261 I O 0%\O
2 7 222 0 000000 0 > 2n
k . t \ rn k c m>c c m A m �m co�
n 2 \ r ■z - m o
0 » 0 / 0X
t / 0 z
0
§ zi
rkk 0
z
k�
% m o 2 2m hi
z 73 m
Z § § 000000
$ J K ? / . m"aCo ■ ■ -a
- q m § 7 s& � 0 0
0 . mz ■ -0 0
0 n 117 7-1 so Z
/k 2 rx xi 73 73 Lo m krs ' mX
/ zxxFl 0
z 0 r §§ 0 , m
0 o
>
$ 2 2
rto > 0 g000Oo .
< Q23 -nn o
q Ammo ' 2
I, _0
0
\5 � �z k
of pR�o� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE v /c'
Lt:
il
AND UTILITY CONNECTION PERMIT 6 (�/
U
I. White File PERMIT NO. // Z6,
��NNES��P 2 Pink City cp
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
/ /: ZONING(office use)
?57 4 h i(44,01 CC 'Prior 6.4.e. , 5 3-7 Z_
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER 1_,Il � C tt&kI z• ro( I
(Name) (Phone) 352 2 33 Lit 4.5
(Address)
BUILDER (Phone)
(Company Name)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New ConstructionDeck ❑Porch ❑Re-Roofing [Me-Siding ❑Lower Level Finish 0 Fireplace
❑Addition ❑Alter io ❑Utility Connection
1
❑misc.CODE:OI.R.C. ❑I.B.C. (Q
Type of nstruction: I II III IV V A B U •
PROJECT COST/VALUE $
Occupancy Group: ABE F HI MR S (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have furnished informati• 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 proper and that all constrir tion 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 revoke th.. ier Ar ju i cause. F 'thermore,I hereby agree that the city official or a enter upon the property to perform needed inspection..
designee may
I __
g igna_ . 5 Da
1
Contractor's License No.
/
Permit Valuation �P r
$ 2 00 o. 60 Park Support Fee # $
3 _s'� SAC # $
Permit Fee
Plan Check Fee $ �'j(Q, r 3 Water Meter Size 5/8"; 1"; $
State Surcharge $ 3_ o 0
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 $ 12, (. (43
This App1i "on t ecomes Your Building Permit Wh• Ap''oved Paid 7,2 / 4,3 BRya.
I
4 -- Date 6- /G
iildi g Official
This is to certify t ,t c request in the above application and accompanying documen.is in a, ordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by 4 ' y Tanner constitutes a temporary Certificate of Zoning compl,nce a . allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued '
h.�/_ ' Special Conditions,if any
r•lanning Direeft OW
24 hour notice for al inspections(952)447-9850
4646 Dakota Street Prior Lake,MN 55372