HomeMy WebLinkAboutBuilding Permit #12-0617 � ❑O n 0�0�0❑ � O A =n
� � �� O u,,,=�no�, O� v�
0 0 � �zv, g Z m � m
� � o � � � 3 m ��3z� "' � t�" ��
� � � m m y m N szsZ o y o�
p � -�i � � � m ���+� _�
� �� y � z Z ��
� � _?� z o z m�
� m
� z �
�
-� � � �
_ ,� � v
� m � o o , ❑❑❑O�O �
m m m m 3�ui��'o _ f
,O� � y O O nC��nC rJ
� �e Z � ���7o w m p �
� � m � >� 3 Z � o
�° r�00 � � � m
� � = Zcc = �
C = � � . .v O o
� A � �
� � m .......
� C � (f1 ,V
y m ❑00000
� = 2 ���OL� � �, - � i
� G � r' � m
�' < _ �
D m �5� o �--
z ��z�
� >_mm
m ����� s
� �g � _ „
5
a� � CITY OF PRIOR LAKE BUILDING PERMIT,� ��` �� Date Rec'd
��' � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
v � AND UTILITY CONNECTION PERMIT
�
j �'N � S��
l. White File pE�IT NO . ! L y�
2. Pink City / Lr
3. Yellow Applicant
Please e or rint and si at bottom
ADDRESS ZONIl�TG (office use)
8 ��: � �� 10� /Y1'� l�
�� � ��-
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER '� a , 7. �
(Name) � (Phone)
(Addres�} . _��.___� Y..._��� �
BUII.,DER �� � 7
(Company Name) C(Phone)
(Contact Name) 1 (Phone) ' `�""�
(Address) � �
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing Re-Sidin ❑Lower Leve�l Fin � �❑ Fireplace
❑Addirion ❑Alteration ❑Utility Connecrion l.tf ��-o w
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc:
Type of Construction: I II III IV V A B Q��oQ�� ��
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ o`G
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have fiimished information on this application which is to the best of my knowledge ave and correct. I also certify that I am the owner or authorized agent for the
above-men ' roperty and that a on ction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official c revoke 's permit for just aus F , hereby agree that the city official a designee may enter upo the operry to perform needed inspections.
X ���� � �� � -�/ -/�.
re Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ �;�t� Water Meter Size 5/8"; 1"; �$
State Surcharge _ �:r' ' ;� ,��,� Pressure Reducer $
Penalty ���c�, ~ ' �$��4 � L � �� Sewer/Water Connection Fee # $
.. S
Plumbing Permit Fee ,��'�i J��,���� St��`� , c�CA' Water Tower Fee # $
Mechanical Pe ee��� �m�+ `Gj� �e� Builder's Deposit $
Sewer & P t ��* ,�G' Other $
Gas Firep e��G ,� ` TOTAL DUE $
�
Tlus App comes our Building Permit When Approved Paid ReC i t 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. This document
when signed by the City Planner constitutes a temporary 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 (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372