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HomeMy WebLinkAboutBuilding Permit 13. 1191 I O 0 000000 - 0 0 > ■n 2 § n $ o o 0 0 q z (n v o z m % � 73 c o m 0 © m ■ -4 § §z O 0) � /3 F) q$ . 2 m -©&® z■ k » d ° � m q J d C ¢ � kg. / \� m� 2 7' s § 7 �. ` 1 x \ m m m �. Z \ o 6) 7 u ooOODO 373 m m . �r ®t�� � . o -4 o o « mr Inc , \ ■■ n ■ '; ;I m § \ MO ° § kK §§ K f ¢ y c0 - \ Z x22 - z w c $ § o N \\ � k■1 % x m & c § . m 000000 2 § 0m2 § § | 2 a. Q ,) x§99 t 0 ( �� ■ ?mm� 7 m � � 2 2 § m r ■ CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec (4;o. , TEMPORARY CERTIFICATE OF ZONING COMPLIANCE v AND UTILITY CONNECTION PERMIT /D Z . / + .NNESO t. I. White File PERMIT NO . /3 / 2 Pink City / 3 _. /( / 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS Z G (office use) +S )\) i \ Q'bOTS. Y11 " VV (` xb c=. k_4 ) Nl 651D. iJ • LEGAL DESCRIPTION (office use only) LOT f BLOCK / ADDITION ,;, /dee 4)4&7 e y �-�, PID If) ) 3 e OWNER (Name) 0.y \ow-A 1l�d\\ (Phone) SS L i t- 1D =11)11 (Address) ?a: S . .A l.kz, - c{ l 1 1 -- lAz, -12 rJ'S31 a, BUILDER (Company Name) (2.c* 1A"5 9'P ar4 (Phone) qa. $�A ' (Contact Name) ' leCxv'S 1-1\12.yla ry i (Phone) 2a - '4� L\ (Address) ;tom \ �(-c, Ac c,-, 1'°)4 \ �J1Dcank.A'ar. t �- � (fl TYPE OF WORK 0 New Construction ['Deck ❑Porch te- Roofing ['Re- Siding ❑Lower Level Finish 0 Fireplace ['Addition DAlteration ❑Utility Connection CODE: DI.R.C. DI.B.C. 0 Misc. _ Type of Construction: I II III IV V A B Occupancy Group: A B E F H I M R S U PROJECT COST /VALUE $ (excluding land) Division: 1 2 3 4 5 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 1 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 permit for - use cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. V - (0 Sc k C ) a6 ) aetA Signature Contractor's License No. Dat Permit Valuation Park Support Fee # $ Permit Fee 5 7 ` 7-5 SAC # $ Plan Check Fee $ - 6j) Water Meter Size 5/8 "; I"; $ State Surcharge $ Pressure Reducer $ Penalty $- Sewer /Water Connection Fee # $ Plumbing Permit Fee $ Tower Fee # $ Mechanical Permit Fee $ r 1 Builder's Deposit $ Sewer & Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL DUE $ c 7S This Application Becomes Your Building Permit When Approved id 19, 7� j Z- Receipt No. ` 0 -- P id By -� . tiding Offi • •al Date s .-. 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