HomeMy WebLinkAboutBuilding Permit #12-258 ; o❑ c� a❑000 = o o z�
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oF PRj CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ���
v �
AND UTILITY CONNECTION PERMIT I � r �
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~�A'NE9��� I White File /� ' �
Z �;�� � PERMIT NO.
3 Yellow Applicant
r rint and si at bottom)
ADDRESS � ZOI�TING ioft'ice use)
t � � � �
LEGAL DESCRIPTION (osfice use only)
LOT BLOCK ADDITION PID
O
(Name) 'i � 3 d� (Phone)
(Address)
B � j / �7�/
ompany Name � h ✓ � � G� � (Phone) ` � / � ' / �1' 3 "� � �
ontact Name � /' r` �, �-a � (Ph�
ress ' .S�' e 7� i � ,� _ �j�d
TYPE OF WORK ❑ New Consauction ❑Deck ❑Porch Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Urility Conne i
CODE: ❑I.R.C. �I.B.C. ❑ Misc.
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: 1 2 3 4 5
I hereby certify that [ h shed infor tion un this application which is ro the best of my knowledge true and correct. i also certify that I am the owner �x authurized agent for the
above-mennon �ity nd ll nstruction will conform to all existing state and local laws and will proceed in accordance with submittcd plans. I am aware that the buildmg
ufficial can revok is r � cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform necded inspections.
X .-------_.. ��5�6a S� —��
onaa o. 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 DIJE $
This Application Becomes Your Building Permit When Approved Paid Rece' No.
Date l B
Buildins Utlicial Date
Th�s �s to certify that the requcst in the above applicahon and accompanying documents is in accordance with the Ciry Zoning Ordinance and may proceed as requcsted. Th�s document
whcn signed by the City Planner constitutes a temporary Certlficate of Zoning compliance and alluws construction to commence. Before uccupancy, a Certiticate uf Occupancy must bc
issucd
Planning Director Da[e Special Conditions, if any
24 hour noticc for all inspcctions (952) 447-9850, fax (952) 447-4245
4646 Dakota Sveet Prior Lake, MN 55372