HomeMy WebLinkAboutBUILDING PERMIT 16-816 DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED /2c/7, �
ADDRESS 5(0,-74 0.Q4:9_424
OWNER CONTR.
4,PHONE NO. PERMIT NO. i
0% FR1O.1? CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
ti TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ,-7 2 a , tb
AND UTILITY CONNECTION PERMIT
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1.White File 'I PERMIT NO. /6, / (�,
2. Pink City �/
3.Yellow Applicant
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ease type or print and sign at bottom)
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DRESS ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCKADDITION PID
(Narrle R f ms S +C (Phone) q . ✓"► ✓ • s%�C VV'`�
(Address) Vt i (r&{1(i r oC Th' 'v 5
BUILDER 1,kiVZ--(:)'
i (Phone) / � '1 '�i /`(Company Name) y L0 ` /U (Phone)(Contact Name) p� ('1 }/ I DIA ��/[/ �/� N r „ .,/ /
(Address) 4. QVr1 u L O f ' 7 4 1 LS f -�► L
TYPE OF WORK 0 New Construction ❑Deck ❑Porchge-Roofing ORe-Siding OLower Level Finish 0 Fireplace
DAddition DAlteration ❑Utility Connection
CODE: I.R.C. I.B.C. 0 Misc:
Type of Construction: I II HI IV V A Bis
D v V
ccupancy Group: A B E F HI MR SU PROJECT COST/VALUE $ �J
vision: 1 2 3 4 5 (excluding land)
I hereb c .at 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
abov- ”,tione.�p-.:a . 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
o r e r ust c use. Furthermore,I hereby agree that the city official oregt�e�ayD tthe property to perform neededpections.f G U 22
X ,,i ,4 gn. re 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 $
This Application Becomes Your Building Permit When Approved Paid /041 - V Rec 'pt No4 2,11--
Date l- 'LZ .( C' By
Building Official Date
This 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 must b
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en signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy
e
ed.
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372