HomeMy WebLinkAboutBuilding Permit #12-238 � O❑ n ❑ �OO❑ � O D Zc�
H
�
N
n n � �°° 3 mac��g Z m � m0
o a o ��� 3 r 3 z-� "� � t ��+
� � "' m m y I'Ti y �z O tn Ov
� � � y � -i m Z�o� ZO
p � O D (/� n Z � �
�j o Z - = � n 7�C
�1 m
� � � Z � V
� r v 1
� T � � C
� ^� � o O 0❑❑❑❑O �
O x z o v m C N � ; c �
y ffl r--
� �c Z � , m p c�
C m � � y6i 3 = m
�° n � O r�00 � � � C
�-� o z z�� z r
O z � T �'°� � o
� A �
S
� � ° N c �
�, m ❑a❑oa❑ � �
" Z � � 'tl 't1 n [n G.1 ,� >
�' z D��OZ m
�' v � ����� � N
� A m�s�p
� n >mm��
� m ��1� 1
� ��- � m
r
oF PRlp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� > TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �� l �
.. � AND UTILITY CONNECTION PERMIT
v �,
���NBS��� 1. White File � .
2 �;�� � PERMIT NO. ��
3 Yellow Applicant �
Please e or rint and si at bottom}
ADDRESS ZONING (ot't use)
! 4� a c� ' I �� ���k' L��-� r 5 E
LEGAL DESCRIPTION (oft'ice use only)
LOT BLOCK ADDITION PID
� I �rt �.�.��'r+ 5 (Phone) C� S (� Z �F— �`fy4
(Address) Q,�1 e.- a,5 ct bt► M�.
B DER
(Co an ame} (Phone)
(Con ame) (Phone)
ddress)
TYPE OF WORK � New Construction ❑Deck ❑Porch Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Con ction
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 [ have fu shed information on this application which is to [he best of my knowtedge true and correcc I also certify that I am the owner or authoriud agent for the
abovamennoned pro all iction wil] conform to all existing stare and local laws and will proceed in accordance with s�bmitted ptans. I am aware that the buildmg
official can revoke thu i or t ca e. u e, I hereby agree that the ciry official or a designee may enrer upon the property to perform needed inspechons.
X n�} 0 3 r z-
Signature Connacto ' nse No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; l"; $
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 Buitding Pernvt When Approved Paid - ei t No.
Date � (
Buildin � Ufticial Date
This �s to certify that the requrst in the abuve applicat�on and accompanying documents is in accordance with the Ciry Zoning Ordinanee and may protted as requcsted. ThYs ducument
when signed by the City Planner cunsnmtes a tempurary Crrtifieate uF Zoning compliance and allows construction to commence. Befure �xcupaney, a Certificate uf Occupancy must be
issucd.
Planning Director Date Special Conditions, if any
24 hour noticc for ali inspections {9S2) 447-9850, f:�x (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372