HomeMy WebLinkAboutBuilding Permit #12-355 � o❑ c� ❑ aoa❑ = o o - z�
'" �"' O N „ �n „ � v,
o �� �°� � 3 r��c�c m � m c "' i �
b D � � � 3 r 3 Z-� �n .�
� � m m y ITt y Szyz O y O�
�e+ -�1 � > � Z � ���� _�
c � � � �N � Z Z °�
-�
� � _ > o z m �
m
� o � �
-�1 r, p �
_ � � �
� m °� o � oaaooa
m m m m � 3'�N�;�
� Z � v v =���_� m n n
� C '° � � �� 3 o m
� �
�e � � o ��$� � � �
� o � W � � �c Z �n
�n z � m ��o �v O o
� = m �` ,� �
o �
� � - �e
�
� y r�i IT �O�OO❑ '"
�
� D � ��_�;� N �
� > � m���:� W �
� n >_mm��
� m y'�� � J � �
�� � �
�1
0 � YR ���
�� ,� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
" AND UTILITY CONNECTiUN PERMIT
�
l�
' ""'"` ��` (�PERMIT NO.
2. � �:� I /Z ��:�
3. Yetbw Applicant
PllASC Ot � �IS BL�WttOffi
ADDRESS ZONING (otr�e use)
l lsr I y�I I-�-tt�ssCm �e. S� Pri or �e �+� 5537a.
LEGAL DESCRIPTION (office use c>nty)
LC7T BLOCK ADDTTION PID
OWNER
(Name) A]�r1 �P_f1Y'u (Phone} � e l�- ��o� y IS'rJ
{Add.ress) L�,Q
BUl]:DER � � �� � �
(Company Name) ar' L�C�S. ��L _ {Phone) Q' -u y' 8��`
(Contact Name) �T ,rru ���/c3�g� n (Phone>�-151- Uy5- f�(�3F�
cA�� 1 lo �cu Ie L�oLustr; a.l Lvd. S. f�Fln{
TYPE OF WORK ❑ New Can�ruction ❑Deck []Porch -Roofing �Re.Sid'mg �Lower Levet Fimsh ❑ Fueplace
QAdditbn �Akera.tion DUtility Co
CODE: �LR.G �LB.C. p Mi9c:
Type of Cansm�cHon: I II III IV V A B
O�a�q Group: A B E F H I M R S U PBOJECT COST/YALUE S�,_�� •�
Division: 1 2 3 4 5 (e� land)
I 1�rebY art� that I have lim�islied info�on a� Ifiis applic�tian wl�ich is ro tlu best oFmy 1mow�ledge Kue and cmrect. I at� aertil�r that I am tlu owva ar aulhariaod a�ent fa¢ the
above•menrio� pmperty aad that all coasavction wilt conFocm to all erc�tirg atate and local laws and will p�ocoed in a�cdatece with submitud plens. L am awas that the buiiding
of�ial this permit fa� just cavse. Furttcer�ce, I�y agee tttat the city o@'ociat or a desigree may eater upcm t!� progeety eo pet�OCm needad i�os.
x m�l C�C.���3y� 5-3-i a
Signadue Conaacbor's I.ieense No. Dabe
Peimit Valuadon Park Support Fee # S
Pernrit Fee S SAC # S ,
Plan Check Fee S Water Meter Size 5!8"; 1"; E
State Sutcharge S Pressure Redueer S
Penalty $ SewertWater Conneaioa Fee # $
Plumbing Permit Fee S Water Tower Fee # S
Mechanical Permit F� � Builder's Depasit S
Sewer e& Wa�er Permit Fee S Odier �
Gas Fireptace Fennit Fee $ TQTAL DUE 5 -�
TLis App�allon Bwomes �oor Boilding Permii WLen Approved Paid Recei j
Date
s � ' i�ste
T'hi+ is to � AiAt1Mt ieqr�t Ili 4e above applicataon and accomP�Y�B docum�tt a in ac�co�dance with t}� City Zaniag Ordinance a�i may proceed as reques�ad. 'i'h� docurreent
wh� signcd by dle "��er �bes a oempaiary �ca0e of Zoning �nplianee and allows amatructiw� ov oomrnmoe. Bd'ae oa
issued. O aP��Y, a Certit`xsDe of Oocuptney must be
� ��� � Speciai Canditions, ifaay
24 hoar noEtce Por all inspectlons (932j 4d'7-9650, fax (95� 447�1A5
4646 Dakots Street S.E., Prior Lalu, Minneaots 3.�372
;.
_._ , . ,. a�.:..�'''" �
. :: ,� ;r ,�e a�l+ t,.
��MN[ �
�..
.....�..