HomeMy WebLinkAboutBuilding Permit #12-347 Siding y ❑ O� C) ❑ ❑�O❑ 'v O D =c�
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� q CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
" �' AND UTILITY CONNECTION PERMIT
� ��
f �'NES�
I. W6ite Fik rpERMIT NO . "� �
2. Pink City I— % L, ��y� �
� 3, Yetlow Applicant /
Please e or rint and si n at bottom)
ADDRESS / t j � �/ � S' � Or�(� � ✓1 �, � • ZONING iott use)
T T
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) �2. � � ; C. � � °` � ''�� (Phone) � 1 Z - Z �f D - �� Z- �
(Address) � y 3 � 7 S �.o ,�'Cr L �^ /� � � •
BUII.DER � � h . T� C . 9 ,S Z � 7 � �o - 3 O � (o
(Company Name) �� P' i �J� � �a , (Phone)
(Contact Name) � c K �c�c..�c��_ __ _ _ _ __ (Phone) � � z- � � � g" �O $ � J
(Address) i 3 a I E-� ��+'f� /� ��/ 7 �N �n S v i� lQ, M/ v 5��J,3 �
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 Construction: I II III IV V A B r
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ v` ��� • O
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have fumished information on this applicacion which is to the best of my laowledge We and rnrrecc. I also certify that I am the owner ar authorized agent fm the
above-menaoned pmperty and that all rnnstruction will conform to all existing state and local laws and w�71 proceed in accordance with submitted plans. I am aware that the building
official can revoke thi ermi or just c use. Furthermore, by agree that the city otficial or a designee may enter upon the property to perform needed inspections.
X 0 BC � So �� �7 .5��2-�/ 2_
Signature Contractor's License No. Date
Permit Valuation Paxk Support Fee # $
Permit Fee $ SAC # $
PlanCheckFee $ WaterMeter Size51S"; 1"; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Pernut Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & W ater Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Application Becomes Your Building Permit When Approved Paid Recei t O.
Date �i B
Buildin Official Date
T7�is is ro certify that the request in the above application and accompanying documents is in accordance with the CrtY Zoning Ordinance and may proceed as requested. This documrnt
when signed by the City Planner consututes a temporary Certificate of Zoning rnmpliance and allows construction to commence. Befoze occupancy, a Ceitificate of decupancy must be
issued.
Planning Director Data Special Cqnditions, if .�ny
24 hour notice for all inspectioos (952) 447-9850, fai (952) 447-4245
4646 Dakota Street S.E., PrIor Lake, Minaesota 55372