HomeMy WebLinkAboutBuilding Permit #12-311 y O❑�( C� 0��000 = O � yn
� � O u,„=��,„ o� v ��
n n � �°� 3 m�c;°co m � m c "'��
0 � o � A� 3 r 3z� Z v► ...�
� � � � � � - m 5 ��� � y z�
io � n� N � Z z p�
� � � o c z n�
o = .,,� '� m m
t� O � Z� � f_
� � r � � w
z � � v o�
� z � � � � ooaoo❑ �
'� x m m m m�
� z � � � ���7 m p � c
� c � � � >� 3 z � m
7e n � 0 � 3" p 7� � � '� C
b � o Z 2�� Z r
O � � i - 'O � � � �
� A O
� z m
o ►`�
� c
� �
y °< ❑000a❑ � �
y Z � ,� �1 T n �
� � � ymm3� "'
� � z�55� N
� Z >mmzl
� m �-n��� e
� �z � m
D
o � rtt� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
F ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT � �� ��—
U X
�
'yj L White File . �
2 r; � PERMIT NO. �� ��
, 3 Yellow Appliwm
Please e or rint and si at bottom)
ADDRESS ZONING (ot�ice use)
. !� L , /
'� s I\ ��J.:rs�
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) � � fY1 ��i�5 �� (Phone)
(Address)
BUII..DER /
(CompanyName) � 1�a� ��t,-.v �.�° (Phone) � �Z—�i10'JZ.��]
(Contact Name) (� ( ve y ,. (Phone)
(Address) �'1,� u " � 't
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. � Misc.
Type of Constiuction: I II III N V A B pROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U
(excluding land)
Division: 1 2 3 4 5
I hereby certity that I have fiimished information un this application which is to the best uf my knowledge true and cottect. ! also certify that I am the i�wner ur authorized agent for the
above-mentioned property and that all constniction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official c oke th' permit for just cause. Furthermore, I hereby agree that the ciry official or a designee may enrer upon the property to perform needed mspections.
x - �jC, l5 � `63 �� �f /?�l�lZ
Signature Contractor's License No. Da e
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 $
This Application Becomes Your Building Perntit When Approved Paid i t No.
Date B
Buildin � Utl7cial Date
This is to certify that thc requcst in the abuve applicanon and accompanying documents is in accordance with thc Ciry Zoning Ordinance and may proceeA as requcsted. This document
when signed by the City Planner consututa a tempurary Certificate of Zoning compliance and allows construction ro commence. Befure occupancy, a Ccrtificate uf Occupancy must be
issucd
Planning Director Date Special Conditions, if any
24 hour noticc for al! inspections (9S2) 447-9850, fax (952) 447-4245
4646 Dakota Stteet Prior Lake, MN 55372