HomeMy WebLinkAboutBuilding Permit #11-1089 � ❑ ❑ '� C� ❑��❑O❑ = O D Zc?
n n � � � � 3 mDC�00 = � � m�
0 D o ��� 3 r 3 z� Z � y „ �rt
� � m m N 171 N SzDZ p y p�
� � " � � - m ��� Z�
�o ;� � n v, U� � Z z p�
� ~ o O n � z n�
i z � � � m m
t� O � Z �° (� ( rt
� � � p � 1 J `
� � �
� � � � � 00000❑ ° � l,,
� m m m N p m � y � 3 � �1
.`� C
7�n N�� S; rtl 2$ � p � N
� c � � � � Z �oo�� 3 Z c m
b � ' ° � � '—' � � � � � O °
� � o z � � z r
Z? m � � �vv � v
a A � �
l` m � ...
� � o
y m �. ❑O❑00❑ �
� Z = ��7 `� >
a• o � ����� O -
� �
a m o
55�
t� Z >mmZ,�
^�C rt1 yZ �O� Z N m
�r �
oF rtt� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
.. x AND UTILITY CONNECTION PERMIT � b • I � I
U �r
AqNH�so�° I. Whice File pERMIT NO `
2. Pink City / � / / ) �� �
3 Yellow Applican� � �
Please or rint and si at bottom) � �
ADDRESS ZONING (ott'ice use)
�� l� S W� f� 1� � C� �K `T�2. /� 1�
LEGAL DESCRIPTION (oflice use only)
LOT BLOCK ADDITION PID
OWNER ,4, l,4 l� S Q� l�l�
(Name) (Phone)
(Address) � � � �o S � � � Ci�- �, � �
BUILDER
(Company Name) fl� � � (Phone)
(Contact Name) E�-�s (Phone)��- 2 � 5 � � ���
(Address) �� ��j � l� [ t'�.� � l.(.�
/
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Conne ion
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V A B PROJECT COST/VALLTE S �� ��
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
1 hereby certify t t I have ti�mished information on this application which is w the best of my knowledge true and correct. I atso certify that [ am the owner or authonzed agent for the
above-mennoned perty 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
ufficial can revok s prrmit forjust cause. Furtherm gree that the city official or a designee may enter upon the property to perform needed mspections.
x 2D(� �'7 23 'Z 1� L�7 (
Signatur Contractor's License No. ate
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Ptan 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 Pem�it When Approved Paid R ei t NO.
Date B
Buildin � Utiicial Date
This �s ro certify that the request in the above applicauon and accumpanying documents is in accordance with the City Zoning Ordinance and may proceed as requcsted. 7'hrs document
when signrd by the City Planner consamtrs a remporary Certificate of Zoning compliance and allows construction to commence. Before uccupancy, a Ce�tificate uf Occupancy must be
, issucd
Planning Director Date Special Conditions, if any
24 hour noticc for All inspections (9S2) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372