HomeMy WebLinkAboutBuilding Permit 11. 1270 413
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CPRIp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �� 2 Z
Pt
AND UTILITY CONNECTION PERMIT
127
rgg0t� I. White File
z City PERMIT NO. f/ /z 76
3 Yellow Applicant / �/J
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
333 U3 Wort. t,S& 1 y
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
(Name) (3(}b. \ C (Phone) \Q`1-.'{ZS(o. t`4 u
(Address) 3 c3 a(Sa Ox-sQGbd n;G9, Qr - Lac„.... f S'S r)
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction Deck ❑Porch ORe-Roofing ❑Re-Siding ['Lower Level Finish ❑Fireplace
['Addition ['AlterIon ['Utility Connection
CODE: ❑I.R.C. ❑I.B.C. 0 Misc.
Type of Construction: I II III IV V A B •
Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $
Division: 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
ntioned pro • 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
offici can vok s p mit for just cause Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X C AA \\44.-`\
Signature Contractor's License No. Date
Permit Valuation 4- 0 Ery C> 0 0 Park Support Fee # $
,
Permit Fee $ /0_3_ 60 SAC # $
Plan Check Fee $ &C-/ <lj Water Meter Size 5/8"; 1"; $
State Surcharge $ 2 `/Q 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 $ /-7 ---
„,
This 1.1 a . Becomes-Your Building Permit Wh App ved Paid t't(.
1 -3 Receipt No. Co f--Coq''c
Date I(r'Z'L-`( ‘ By
ding Official . Date
This is to certify that/, •re.1' tin the above applicatrton and accompanying docume is is in ccordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the r t PI er constitutes a temporary Certificate of Zoning com lance a d allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued ,
,N har II' 2-Z
'i anning Director Date Special Conditions,if any
e for all inspections(952)447-9850,fax(952)447-4245
'6 Dakota Street Prior Lake,MN 55372
DE
TMENT
F
PRIOR LAKE BUILDING A DOINSPECTION
INSPECTION
RECORD
SITE ADDRESS 3.332 MLA)L.V) (`rDi2d'G �FJSS
TYPE OF WORK 066/C
USE OF BUILDING /2-Cr /I/`'L
PERMIT NO. / 1. /7--,.? DATE ISSUED i/ Z Z. � /
BUILDER /Sejs,,CfPHONE it 6/2. 9b6 . 3/6 0
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DATEI FOOTING 744;PLACE NO CONCRETE UNTIL ABO AS BEEN SIGNED
111111111116
I FINAL Ci I pt 1118 /4
FOR ALL INSPECTIONS (952) 447-9850