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HomeMy WebLinkAboutBuilding Permit 12. 0913 LI W = 2 tv a� 1 ? 0 0 w Z w �1 �a da g� l i :1 1 u'�UU u .c� 2 ? t.� t ❑❑❑00'5( > o U 00 W = a W N c. pc ' \' . z w O >> a m c O 4 C xz a r te F' a 0 0 ". -3 0 Q V g \ LO v O w Z sxzz �. w c a a N 0 a m =Warn ' a 6 Z i a. n Ct tiV v ` O CL25COn LU ,� W W W W k ' P 8 a z ❑ ❑ ❑DD❑ a a o to O. a U. cc 111 tu YV ,` Z O Z V U W 5 P p ao a O z � SI u. V O t: Ot p Z a 0 p W 1- F .4 3 ty a p N O Z N 11. Z .J N V v W O . 2 W " O W w W Z L__ 0 12 0 .2 t m O O O t 0 C.) ai ° p. O u. u F. T. 0 0 3 v 0 I. ESz 4 O a ❑00 ❑D❑ 0 Cl ❑ JE 0 I PiI;;. CITY OF PRIOR LAKE BUILDING PERMIT, Date Reed TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 4 r4 AND UTILITY CONNECTION PERMIT U 4:r4NESOlt' t. White Fite y � 7 �� 11 //yy 2. Pink City PERMIT NO. / ^ 0 /3 3 Yellow Applitani (Please type or print and sign at bottom) ADDRESS ZONING (office use) L./ lloon:rii 13)./.4 7 tr.Q.i# ( LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER P;:1YI)/ 6 r� .. (Phone) 9 1 � O 3 ' /17Rj (Address) 9 M- 1 NreP erfeel / (Company Name) ,r, ' 4 7 .s 4, .. C y /''e J (Phone) 667- 5?S (Contact Name) C 4 - Phone) v (Address) /di / �j�+ v , c 5 � 4 /1--ii U �N •$‘6 TYPE OF WORK 0 New Construction ['Deck ['Porch e- Roofing DRe- Siding ❑Lower Level Finish 0 Fireplace DAddition DAlteration ['Utility Conne i n CODE: DI.R.C. DI.B.C. 0 Misc. Type of Construction: I II III IV V A B /s � Occupancy Group: A B E F H I M R S U PROJECT COST /VALUE $ 43 I`/ Division: 1 2 3 4 5 (excluding land) 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 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 it or just cause. Furthermore I hereby agree that the city official or a designee may enter u on the property to perform needed snspcctu s. P 40/26/z. 1 X - d 7 .' ____&:' V7 4 / 497 7 Signature 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 $ 7 9 7 4 This Application Becomes Your Building Permit When Approved Paid N,. s Receipt o., 1 1 716 Date B s - _ .__ 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 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. 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