HomeMy WebLinkAboutBuilding Permit 10.892 _ 0 1§
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of PRf CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / G /0
.. AND UTILITY CONNECTION PERMIT
U
/2-I P4co4'ti/
M1NNEso I. White File PERMIT NO .
2. Pink City /0 092
3 Yellow Applicant r
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
X /C y `? ('/ j )-- Av S eg— R,/,50
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION POI --. a ea I f( PID z� 0 11 r 0 0 3 d
i OWNER (.'
(Name) roc -t S 1 7° U t° i se9 (Phone) re ti
(Address) Sa,/YL.C____ el c Z Y t / W eY '/ Y qS
BUILDER
(Company Name) (7�1/1 (Phone)
Y- (Contact Name) S ' C' 1 f (Phone)
(Address)
y TYPE OF WORK ❑ New Construction ❑Deck ❑Porch We -Ro ing ❑Re- Siding ['Lower Level Finish ❑ Fireplace ,/�
❑Addition ,,alteration ❑Utility Connection .e NAGVe, (4c.....(9- I 5" C...... •••• ID - m Ti V rr 4- ICeoc-
CODE: L R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V A B //����
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $ S �
Division: 1 2 3 4 5 (excluding land)
1 hereby certify that I have punished 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 . tl -xff•t`yffsnuction "will• form to all,gffjsting state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official evoke this per or . 1 ..s . • Tnee eny 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 000 Park Support Fee # $
Permit Fee $ i,, .15 SAC # $ •
Plan Check Fee $ 1(9•54 Water Meter Size 5/8 "; 1 "; $
State Surcharge $ 2.50 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 C - r) 10 ( 0 $ (9/O . is
Thi • • • pplic t n :. • comes Your Building Permit en Approved Paid g(,,' 9 R pt No. I9'7
4 1 i fa . Date /0, b,/0 B
BuildinaR=fillallIP 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
when 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
issued.
''' -....., / A (...... 1/,,/--#1e
•lanni 1 irector 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
1
PRIOR LAKE BUILDRNG AND �N SPECTION
INSPECTION
RECORD
SITE ADDRESS /5747 WesT
TYPE OF WORK � � -sJe:S1 /2,6(1)
USE OF BUILDING 2-e /VA--
PERMIT NO. /d . O DATE ISSUED /U- 6 ' 10
BUILDER STEVE/LSU/ PHONE # 9 52 - `f - 14Y3
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
\\{ THE PERMIT IS BY SEPARATE DOCUMENT
CON :5‘ INSPECTOR DATE E
011.111111111 I I
PLACE NO CONCRETE UNTIL T VE H S. BEEN SIGNED
FRAMING �Tksu(,�.r� I `� /), � I
FINAL 1 n /a&
FOR ALL INSPECTIONS (952) 447 -9850
NC •
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