HomeMy WebLinkAboutBuilding Permit #11-0935 y ❑ p� C> DOOOOO = O D� N�
n A � o 0 0 3 N�+y�oo m � m mo
c
cc ' r� c� c� y m y�sz> o� N p�
� � '� � - m ��� ' z-
p m c � N o Z Z 6� O�
�° � � o = � m m
� p � Z � ..-0
� � � o �
„ � �o
� m � � � Q OOOODO �
o� z o v m c y ��c �
� s c
x;��=� � p �
C� � � zZxs� m m
� � � � o ���g " � � v
� o � W �cc � Z � �
�„° z� m �'°� � T v
� � �°
O � n
A , � �1/
� y m 0 � � � 0 0 � �
� o � ��°�°�� �
C��'o
� n >mm��
� m ��� �r �
�� �
oF PRIp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �/ S- //
.�. X AND UTILITY CONNECTION PERMIT �
� �
�Yj I. Whi�e File
2. Pink ��� PERMIT NO. // �S
3 Yellow Applicant
Please or rint and si at bottom
ADDRESS ZONING (o�t'ice use)
Z� 7��A�t/k�rnl C !,c .
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
owivER �� �� J� (� L. Z 7� 5 3 z 3
(Name) �/ (Phone) �
(Address) ���,�
BUII.,DER � `�
(Company Name) �N' 3 ��'� e�NS/� • (Phone) 1�S Z
(Contact Name ��ksT iw� (Phone) � Z� 7�S O
(Address) 2 S . > � 7T�..� L�� .8 � ✓�
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch e-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Urility Conn ti
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
1 hereby certify t a e fum hed information n this application which is to the best of my knowledge true and correct. I also certify that I am the ��wner or authonzed agent for the
above-mennon prop • an t at a nstruc n 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 re uke thi rmi se. a e, I hereb that the ciry official or a designee may enter upon the property to perform necded msp • tions.
X Zo�3923o is �
Signa e Contractor's License No. Da e
Pe aluation 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 Fireplace Permit Fee $ TOTAL DUE $ , '1
This Application Becomes Your Building Perntit Whrn Approved Paid Re t No.
Date
Buildin � Utticial Date
This u to certify that the requcst in the abuve applicahon and accumpanying documents is in accordance with thc Ciry Znning Ordinance and may proceeA as requcsted. This document
when signed by the City Pl�nner consututes a temporary Certificate of Zoning compliance and atlows construction tu commence. Befure occupancy a C�7uficuc uf Occupancy must be
ISSUI'd.
Planning Director Date Special Conditions, if any
24 hour noticc for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372