HomeMy WebLinkAboutBuilding Permit #12-308 � 0❑/� C� ❑ ❑❑O❑ � O D Zn
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�� P CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
U ( �� �� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE -� � Z
� AND UTILITY CONNECTION PERMIT �' � ~
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I. White File pERMIT NO . ��
2. Rnk Ciry
3. Yellow Applicant 1J
lease or rint and si at bottom
ADDRESS ZONING (ofl�ce use)
{ �� . � r il
LEGAL DESCRIPTION (o�ice use only)
LOT BLOCK ADDITION PID
�aWNER �lr l � ��v� rL (Phone) G�/ �—rr��l�I��
(Address)
BUILDER ( �� (Phone) 9�� J� vl �/ V I l 1
(Company Name) q �
(Contact Name) \ f1 � rn�n �l �1 YY]r' (Phone) �Z �! �� I L/ �
(Address) r
TYPE OF WORK ❑ New Construction �Deck �Porch Re-Roofing �Re-Siding ❑Lower Level Finish ❑ Fireplace
�Addition �Alterarion ❑Utiliry Conne ion
CODE: �I.R.C. �I.B.C. ❑ M�s��
Type of Constnution: I II III IV V A B
Occupancy Gmup: A B E F Ii I M R S U PROJECT COST/VALUE S
Division: 1 2 3 4 5 (excluding land)
I hereby ceRify that I have furnished inFormation this application whidt is to the best of my knowledge true and correa. 1 also certify tha[ I am the owner or authorized agent for the
above-mrndoned Qroperty and that all �nsw on will mnform to all existing state and local laws and will proceed in accordance with submitted ptans. I am awaze that the building
official can revoke this permit for just cause. Furtherm I hereby agree that the city offic' r a designee may enre� upon the property to perform needed in ions.
X
Si Con or s L nse 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 S Other s
Gas Fireplace Permit Fee $ TOTAL DUE $
Tdis Application Bernmes Your Building Permit When Approved Paid R ' t No.
Date . Z.� / 2— B
Buildin Ofticial Date
This is to certify that the request in the above application and accompanying documents is in acrnrdance with the City Zoning Ordinance and may proceed as requested. This document
w6en signed by the City Planner rnnstitutes a temporary Certificate of Zoning wmpliance and allows consauction to rnmmence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director Dete Special Conditions, if any
24 dour notice for all iaspection� (452) 447-9850, fax (952) 449-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372