HomeMy WebLinkAboutBuilding Permit #12-0451 y ❑❑� n O ❑O00 � O D yn
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� � CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec d
� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
" `� AND UTILITY CONNECTION PERMIT
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�. w�,��e F��e pERMIT NO. Z_�Jr`
2. Pink City
3. Yetlow Applicant
lease e or rint and si at bottom
ADDRESS ZONING (oe'ice use)
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LEGAL DESCRIPTION (ofl['ice use only)
LOT BLOCK ADDITION PID
OWNER .
(Name) �al'II�E� �- ��ra � 4VI (Phone) c��L
(Address) /�z6 C�+r e�W r I'7c�(� �.. /�lU S 72
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(CompanyName} 5��a„u t�h5'��-�1� C� 1nc_ (Phone) 952 ��
(Contact Name) �eU 4 ►� Sa n da c,�- (Phone) ��2 - 3 63 ^!J/2 d
(Address) �q � a � V�2 Q f � /t�
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Sidiag ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Connection
CODE ❑I.R.c. ❑i.B.c. [���: Tns�ll ��nl�eeme.�j' wrna��,as � I rcplace
Type of Construction: I II III N V A B doc�l'^. ' J d ��
Occupancy Group: A B E F H I M R S U �OJECT COST/VALiTE $ 67 2 7•
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have Cumished information on this applicadon which is to the best of my ]rnowledge true and correct. I also certify at am the owna or authmized t for the
above-mentioned property and that all rnnstruction will confrnm to all existing state local laws and will proceed in accordance with submitted plans. I am aware that the building
offici ievok p for just cause. Furthermore, I h by a�ee at the ciry cial or a designee may enta upon the property to perForm needed inspections.
,- �.�� �����:� G � C3�(�O 72�/ _ � /6 / 2-
Signature Conh�actor'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 $
Tlus Application Becames Your Building Permit When Approved Paid Recei NO.
Date B
Buildin Official Date
This 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. T'his docummt
when signed by the City Planner constitures a temporary Certificate of Zoning compliantt and allows constntction to commence. Before occupancy, a Catificate of Occupancy mvst be
issued.
Planning D'vector Date Speciel Conditions, if auy
24 hour notice for all inspecNons (952) 447-9850, faz (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372