HomeMy WebLinkAboutBuilding Permit 13. 0985 ' n O OCO0 NI 0 > § n
n n 0 § § K . 0 gvAkkk z m z m2
§ r ri 7"ax 3 � rc ■z0 M0
m m m ■ � ■o ■ ■
§ t qi. z in g ®qQ P Z§
0 ® 0 ■ q z z - § ■
t � 0 z 8 z o x
d o > 2 q _ ��
§ ■
rn
X0O & 000000
Z HA2 E71 ■ * s ' §
/ s § § �11
�- � E � � E
■ ■ mmi .0 n ■
7 z f § ■ ■ ■ _ ■ m
2 e \ zExx E0 § 0 §
§ 0 0
U
P r- § § ■ c
§ z # m r- -0 -a
/ P — m
rIV
q
k 0 CA
0 . ❑ 00000
q §® 222 §§
t g
Ammc ® .
43 0 > mmt
- -
r ��
cn-Ir 0
o4 P14.°4 CITY OF PRIOR LAKE BUILDING PERMIT, C- Date Rec'd
, N TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
Z.".1 AND UTILITY CONNECTION PERMIT
,►!..1VifEgOgl: I. White File
12_ Pink City PERMIT NO. �� (J//�-
3 Yellow Applicant 7 d
type or print and sign at bottom)
e
DRESS ZONING(office use)
5 `�
AA I‘ �j( r(:' �IrGt1
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER --}1
(Name) I N re_S[G KLUVILIACV (Phone) 10(52) 495 1165 1--ionie,
(Address) L(591 ` y1G( IrjiYC� Ta t
BUILDER(Company
"` � �J,
(Company Name) `.l & "�1 7'✓�I (Phone) COS(. 4'57 --O'S9 /
(Contact Name) iAl dS4 Sa1f42-72 (Phone)LOS t * `f 57 —03 5
(Address) 111 t(Th ?v - N tS q St- RA, 1 MN 556-is
TYPE OF WORK 0 New Construction ❑Deck ❑Porch Re-Roofing ❑Re-Siding DLower Level Finish 0 Fireplace
❑Addition DAlteration ❑Utility Conn tion
CODE: DI.R.C. ❑4I.B.C. 0 Misc.
e of Construction: I H III IV V A B I /�!l
pancy Group: ABE F HI MR SU PROJECT COST/VALUE $ I �UU
isiion: 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-menti.ned 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. v .q s.- 't for just castofficial Furthermore,I hereby agree that the city or designee may enter upon the property to perform needed mspec sins.
X lcGI' ...4....d. e cQYYd0 3 o 9 i v c3
Sig . e 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 $ d 9' 7S
This Application Becomes Your Building Permit When Approved Paid 77, J( Receipt o, 76 0 d 9
Date q//04.3 BY A.-,4
Building Official Date
fcds 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
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
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