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HomeMy WebLinkAboutBuilding Permit 13. 0570 5 ❑ ❑ C) ❑ D0DD = 0 > 20 LA lit 0 n � O cn ?iz . n 0 0 0 c- 71zu„XJoo zz m ° z m � n m>c C0 m N O .,_ hi m m N i m y gvz Z cn - --i ?...1 Z 3 '� I - O Z 5 t ;1 D N -4 m 0 O (7 Z -� z 73 E • t z -n z n m n m D z m � � • 33 r 4. 5 i m ' °� 0 0 ►� 000000 0 1 m m m m . 17th *Ev z v v �MP OC -I nc v 0 cn v �� z�xo x3 mx3 3 z ` m Do rn n 0 , r xr _1 P ,, 0 m ' o z i 2 7:7C C Z r O 0 m r -o-0 O m A 0 r Z m c o 0 can m 000000 �� ti z z b xi�o J --4 ct • D 0 A D�p > m A 0 tn 0 DmmZ -t co z z m -I r 0 4 PR/O �' CITY OF PRIOR LAKE BUILDING PERMIT, Date ec d , c o TEMPORARY CERTIFICATE OF ZONING COMPLIANCE � ` U AND UTILITY CONNECTION PERMIT l �- d , �'N ES I. white File 2. Pink City PERMIT NO. /3 t1 5''rd 3. Yellow Applicant (Please type or print and sign at bottom) ADDRESS ( .51" ZONING (office use) i(d)ff 1,2). 0.. v R )5 LEGAL DESCRIPTION (office use only) LOT BLOCK i ADDITION pro/e.. 4c,EfS 3 2C1 A h b/v PID "5 0 / Ll 0o&__0 OWNER t �� u ?:5-c- 40 _ (Name) 6 k &3t (Phone) (Address) vA -iene BUILDER Q (Company Name) ••:r la ..- ..- 9 iv ... • (Phone) g00 �p -s-,_q.5 (Contact Name) t j ' . (Phone) bi 3 - Slot (Address) 96.1>j F- 310YSmr ri es ./ 15 , 6:›rr1(y ,3 , ` A) J SU r` TYPE OF WORK ❑ New Construction ['Deck ['Porch Xe- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace ❑Addition ❑Alteration ['Utility Connection ' CODE: ❑I.R.C. ❑I.B.C. ❑ Misc: Type of Construction: I II III IV V A B ex Occupancy Group: A B E F H I M R S U PROJECT COST /VALUE $ g1/4? Division: 1 2 3 4 5 (excluding land) 1 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 thi ermit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X _ _ :. 6d V30 4.-3-L3 Signature �' —._ Contractor's License No. Date Permit Valuation Park Support Fee # $ Permit Fee $ 14 . 7 J C' SAC # $ Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $ State Surcharge _2-C" v 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 $ 77 7J- , This Ap lication Becomes Your t . ng4ermit hen proved 1� . � �� Recei. t No. MIME= b ( © /( �i0ate( I p ' By <77 ,( uildi • al Date This is to certify that t e 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 S.E., Prior Lake, Minnesota 55372