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HomeMy WebLinkAboutBuilding Permit 12. 1154 _ 0 0 A C) 000000 7 0 > %8 O co 22 � 0 en $ o O ^ k ka cR m q § qq / 0 q 22 « �$ ®® z $ -..1-0 b r R § A m m% wQ >0 P 2§ 2 k -4 } § § / \ ' 0 \ 7 m 2 0 0 k M \ Po m Z q - 0 > © \ X r- 0 : M w 0 0 000000 % m m mm c / ® tC2 \ x % §§ � � \� § $2 § -o 0 �\ @ n_ k D 0 § § 2 tl / $ $ \ / \ \ § q @ 0 ~ 0 / z / kk P ` Ln z 0 §2 \ X �� 73 • k m � OOOOO \ z > X7 30 § ' X014 -a \ \ \ I mC) »mmZA ^ r \ -1E E: . ¥ 0 o PR � CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd 0,� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE v ri AND UTILITY CONNECTION PERMIT 9.ft...1411).4. M %HNESOOt 1. White File 2. Pink City PERMIT NO. / 1 / 16 ; 3 Yellow Applicant d� `� (Please type or print and sign at bottom) ADDRESS i(.7,C5 6 i `` ZONING (office use) . LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER (Name) ' (Phone) • (Address) y(6 (o L-(J II. • • S I` ?c:.-d e h A,k m tl 1 (Co DER CJ -1 c 1 c- C3 (Phone) (Company Name) / G m - t /)9 �D O (Ph c �t, + r ,� r (Contact Name) C (Phone) 4 T "-- � > — i 7 t — 5 7 (Address) 5730 J ,..n -t / ` 7 7, • 6 _ TYPE OF WORK ❑ New Construction ❑Deck ❑Porch e- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace ❑Addition ❑Alteration ❑Utility Conne 'on CODE: ❑I.R.C. ❑I.B.C. ❑ Misc. Type of Construction: I II III IV V A B PROJECT COST /VALUE $ Occupancy Group: A B E F HI MR S U (excluding land) Division: 1 2 3 4 5 1 I hereb t I have lumished 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 ab - mentioned pr 'my and that all construction will conform t all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building - t ' icial can revoke chi permit for rust cause. t � t / ore, I here, agree that the city official or a designee may enter upon the property to perform needed inspections - ■ Signature Contractor's License No. Date Permit Va . ation Park Support Fee # $ Permi ee $ SAC # $ Plan Check Fee $ Water Meter Size 5/8 "; I "; $ 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 I $ TOTAL DUE $ " 7 e ' 7 This Applica ' in Becomes Your Building Permit When Approved Paid (jY/r Receipt No. '�p7 C� / p ) Date t By ♦ ' Bit ildine Utticial 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