HomeMy WebLinkAboutBuilding Permit 13. 0821 -(1)..,
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of PR, CITY OF PRIOR LAKE BUILDING PERMIT, Date
,, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Rec'd
cv AND UTILITY CONNECTION PERMIT Z 9
,'rHxesott. I. White NO.
Cityie
2. Pink PERMIT /3
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3 Yellow Applicant
(Please type or print and sign at bottom)
/ADDRESS ZONING(office use)
'_�
_____,__,______ ,,
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER / -?7p Gait
21,J (Name) a r"q (Phone)
(Address) •J
1 BUILDER 4
(Company Name) Ue t1g
eS, `0 /rat/VC�Jt�C C.L-� (Phone) 7� ys - /q
l
/\.- (Contact Name) fl , /< /0-ell 5 (Phone) 7
(Address) //6 SA a, dh: 714; I /7- A �2/ /(//t/ 55 l 2-
Y .
TYPE OF WORK 0 New ConstructionDeck ❑Porch ORe-Roofing ORe-Siding ❑Lower Level Finish 0 Fireplace
DAddition DAltera ion ['Utility Connection
CODE: DI.R.C. DLB.C. 0 Misc. /_,4-//. //\/ f� s/ 7y `S
Type of Construction: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 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 I am the owner or authorized agent for the
above-mentioned property and that all nstru,,.n 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. iu 'fii her e.%e, eby agree that the city official or a designee may enter upon the property to perform needed ins ections.
X .a ' - 4 a 06 R6 7 VO �7�� 7 0201
ignatu - Contractor's License No. Date
Permit Valuation 500, .-- Park Support Fee # $
Permit Fee $ Z S _ — SAC # $
Plan Check Fee $ 1 6-
Z< Water Meter Size 5/8"; 1"; $
State Surcharge $ r SO Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee f $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ 41--S
This Applic.titan;ecome�s Your Building Permit Whe Appro ed Paid 4-1\_."7' Receipt No. P 7 S3 8
/) Date I By /�t -
Atiljt� Z- I 1 1 1
fti., J Pate
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
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PRIO� LAKE DEPABUILDING AND DTMENT �NSPECTION �6�--
INSPECTION
RECORD
SITE ADDRESS /53/3 ED/Ng4K.0 Vrj H
TYPE OF WORK Dewe. ?.oii�.ii/g + S7?9/R1'
USE OF BUILDING tees R/K--
PERMIT NO. 13. 8 Z I DATE ISSUED 7 Sq. /3
BUILDER L�xa�./ REStrK�.irri{-c. �uccvpPHONE # 93-z-45?•cr} Ii
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I ROMP*
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
11411.1i. Toe Gc4440€4g- 1; 11. r. zke(421-ft- tema 4-ifyRiAtr, 1
I FINAL
FOR ALL INSPECTIONS (952) 447-9850