HomeMy WebLinkAboutBuilding Permit #12-487 s ❑❑� c� o�aoa❑ � o> Z�
� n n � O tn = -n � �+ _ ° �
n c� � �° 0 3 za'�°cg m � m r"o
�
� �� � � y m? o� y o�
� � -� � � m o��c� _�
ro � � v, y � = Z � a�
S � °� �+ y o =' �
� ° � D � Z � m�
� � m
� °� � o �
� �
� z � c c
o❑0000
x m m m 3 � y � 3 �
� -� y v o �c ��c ,
x��mx3
� � n N
� � � ? - .- ac 3 Z m
�� 0 2 �_�� � Z� C
o Z � � r "�� � O
� A �
� = m
� c �
� m ❑❑❑000 � �`
`� Z � �f � �n c� � $
� � z D��O� � m
� � � r � � � � �
� Z mnn�v 1
� n a
� m �T��r i
'i � - m
�r �
oF PRtp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE — —
AND UTILITY CONNECTION PERMIT �� Z �`� 2
U X
�
��NNeso�� i wn��e File pERMIT NO .
z ���► r�y �'
3 Yellow Applicam
Please e or rint and si at bottom)
ADDRESS ZOI�TING (of�ice use)
�"�'-�'/ `.a ��/-r/,� t.�"/ C%`�/ � � 7�'� f �—�
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER �� �����
(Name) C�� (Phone) 22� •- ��/ �'J
(Address)
BUII.DER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Urility Con cti n
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Cons�tcuction: I II III N V A B pROJECT COST/VALLTE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 Z 3 4 5
1 hereby certify that I have fumished information un this application which is to the best uf my knowlcdge tnie and correct. I also certify that I am the owner or authonzed agent for thc
above-mennoned 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 buildmg
official can r ke this permit for�e Fuithermore, I hereby agree that the city official or a designee may enter upon the property to perform necded mspections.
� cs o��� �.�—
X —
Signature Contractor's License No. ate
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 Permit When Approved Paid ecei t NO.
Date S' . �`Z,_ ,
Buildins Utlicial Date
Th�s �s ro certify that the requcst in the abuve applicauon and accompanying documents is in accordance with the Ciry Zoning Ordinance and may protted as rcquested. This document
when signed by the Ciry Planner consututes a temporary Certificate of Zoning compliance and atlows construction to commence. Befure uccupancy, a Cemficate of Occupancy must be
issucd.
Planning Director Date Special Conditions, if any
24 hour no[icc for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372