HomeMy WebLinkAboutBuilding Permit #12-0561 � ❑❑� C� D O�O❑ � O A ZC�
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o � PRtp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,, D � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
�' `' �' AND UTILITY CONNECTION PERMIT
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M��'NES��P �. Wh��e File pERMIT NO.
2 Pink City
; Yellow Applicant
Please e or rint and si at bottom)
ADDRESS ZONING (oet�ice use)
ySS Co10� p � �
LEGAL DESCRIPTION (ofiice use anly)
LOT BLOCK ADDITION PID
O aW1VER S�p �1'�Y1 � 1'1�Sd'(1 (Phone) / �pl— �1 �� " � 30 �
(Address) C�► ��
BLTILDER r �� I r r � �,� ,
(Company Name) �n'��� ��.1 � ���� (Phone) �l (SJ7 �' �
(Contact Name) (Phone)
(Address) Q C� • � � � �� (�1(V SS
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace C � ,
❑Addition ❑Alteration ❑Utility Connection � `a� 1 ���( (�)� C��w �.ef��
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V A B l,� 3� I 0
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ W I
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have himished information on this application which is ro the best of my knowledge true and correct. I also certify that I am the owner or authonud agent for the
above-m noned property and that all construction will conform ro all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official n revoke this permi o ust cause. Furthermore, I hereby agree that the ciry official or a designee may enter upon the property to perform necded mspections.
X �G��O/�'3
Signature Contractor's License No. Date
Permit Valuation 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 $
This Application Becomes Your Building Pernut When Approved Paid Recei t NO.
Date B
Buildina Ofticial D�te
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceeA as requested. This document
when signed by the Ciry Planner consututcs a remporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (9S2) 447-4245
4646 Dakota Street Prior Lake, MN 55372
05-23-'12 09:45 FROM-Andersencorp 651-264-4079 T-124 P0001/0001 F-804
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NEW OPENtNGS OR ALTERING OPENING WIDI'H CRITERIA:
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SPAN GF NE1AI HFJIQER ��,,,,,, 7RUSSEB OR IiAND FRAMEO •{� d�"
TYPE Of �IIATERIAI. FOR NEtAI HEADER �
� NU��R OF SUPPORT STt1DS AT EACH END OF HEADER �
NUAABER OF KINQ STUDS AT EACN END OF NEADER ��—
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LOCATION OF�F�AOER (i.e. ga,bto ind w�tl, or othe� e . ,
MEADER 3UPPORTS WHAT'r (I.e.1 toof + 1!loot) 1�nu2 � � Ro��"
SPAN OF EXISTING S'TRUC'rURE AFFECTII�s MEADER a�� •
EXISTII�tG CONSTRUCTlON DE"fAiLS ¢.e. 2r4, 2x6) �
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