HomeMy WebLinkAboutBUILDING PERMIT 16-1273 TOE
4iLY--_DATE
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CITY PRIOROIA cE
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'Z_____2-3-------_OWNER PERMIT NO. 0 EwGRADIFI--
PHONE NO• ❑ PLUMBING RI ❑ X1GRA`ICE RI
❑ MECH RI ❑ FIREPLACE FINAL
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FOOTING ❑ WATER HOOKUP ❑ FIREPLACE
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❑ FOUNDATION ❑ SEWER HOOKUP • GREPLA A
❑ FRAMING 0 PLUMBING FINAL ,4
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❑ FINAL ❑ MECH FINAL
❑ SITE INSPECTION
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ECT ACTION AND P EINSPECTION BEFORE
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REQUIREMENTS
Inspector:A INSPECTION 24 HOURS IN A
OR THE NEXT HEALTH&SAFETY!
CALL 50 F RE FOR YOUR PERSONAL
CODE REQUIREMENTS A ,,more
o- 1'RI � CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
j/' j TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /l Z' j
" ,rn AND UTILITY CONNECTION PERMIT 1
le
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1. White File
2. Pink City PERMIT NO. / , /2.73
3.Yellow Applicant
Ille type or print and sign at bottom)
RESS ZONING(office use)
173 88 S44,t„7 Cr-i4z-E. stAi
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) rd'L(.vf 4 �f i-C2Avtrn.—Ail; (Phone)
(Address) r13 6 k • .dt.....i e. #ciyht_ C kktili S`S3 72._
BUILDER M
(Company Name) in ) 1G tS-(,-t.t //i (Phone) 7 le 3-4-q6- 740 I
(Contact Name) ,TA-ESdY'- t (Phone) Go/Z-Z20 - S163
(Address) it 2,z-7 -0- �!S 4.[ e ti-eH-du Ed__ 1/14S—S-31'1
TYPE OF WORK 0 New Construction ❑Deck ['Porch Ile-Roofing et;-Siding ['Lower Level Finish 0 Fireplace
DAddition DAlteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑Misc:
Type of Construction: I II III IV V A B
illcupancy Group: ABE F HI MR SU PROJECT COST/VALUE $ ZZ/4, 7
ion: 1 2 3 4 5 (excluding land)
ereby 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-revoke this permit for just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X Signature
Eos /Z it/iflc
Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ 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 $ `�(f �Jciei
This Application Becomes Your Building Permit When Approved Paid v0"�- Rec • No. /1— r
Date /(. -7-..---/(i B
Building Official Date
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
is t
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
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372