HomeMy WebLinkAboutBuilding Permit #12-0523 � ❑❑'� C� 0�0�00 � O � Zn
n � a o 0 0 3��N��g x � 70 mp
M � � m m y 1' y O � y p�
e� � � � � - m 0�0� ZO
p v D y N A = _ �
� � ° D z p "�
� �`z�
m
n�'1 O� > Z 7�0
� r � �
_ � v v p,
� m °� � � o00000
� Z m m ;�tn�;�
c �' s m
� � N � � _;��_� � n N
� �e N � m ,��7o��W m p c�
� n � o r�'30� � � � v
� C
� z � m -• ��� � v
� N O
� A p
= m
� O n
� C
y m OOODO❑ I
p�. a � �fnni3C� �
o C�o��
� n >mm�� �
� m ��+8 � �
~ � � c�i
,�
`.� �� pRj ���, CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
" � AND UTILITY CONNECTION PERMIT ��� ��'��
e �
r �'NES��
l. White File pERMIT NO . � � 7 r
2. Pink Ciry G/J
3. Yellow Applicant s
lease e or rint and si at bottom
ADDRESS '3$$2 ' $S aJ��'� ZONING(ot�'iceuse)
LEGAL DESCRIPTION (oflE'ice use only)
LOT BLOCK ADDITION PID
OWNER /� Q /
(Name) r�a. ( l_._ �� , f � 3 S as�'a j`/ Un (Phone) % S 2 2 7 ��` 7 �
(Address)
BUII,DER
(Company Name) � � J �nc � (Phone) 7�3 - 2 0 2- 6 3 y6
(ContactName) �.st�� r��� (Phone) 7�i 3- 20�-�3Y�
(Address) � v�u�.•� �ir, •.t�cc N ,�
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
�Addition ❑Alteration ❑Utility Conne 'on
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc:
Type of Consmution: I II III IV V A B 2 Y 7 9 �
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ /
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and coirect. I also certity that I am the owner or authorized agent for the
above-mendoned pmperty and that all wnstruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am awaze tliat the building
official can rev e is permit for 'ust cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X .£'_..� P�C 32 3 s`t�o s -I Z
Signature Conuactor's License No. Date
Permit V uation 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 FirepIace Permit Fee $ TOTAL DUE $
Tlvs Application Becomes Yo� Building Permit When Approved Paid ReCei NO.
Date �1.� B
Buildin Official Date
T'his is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certi6cate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning D'vector Date Special Condifions, if any
24 hour notice for all iuspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372