HomeMy WebLinkAboutBuilding Permit #12-0769 � O❑� C� ❑ ❑00❑ � O A ZA
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o � PRlp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,, � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �
� � AND UTILITY CONNECTION PERMIT I�-� / Z-
� �
��NNES��� I. White File
z. r���: r� PERMIT NO. �' �_ �
3 Yellow Applicant
Please or rint and si at bottom)
ADDRESS j�� GJ'�,- 1C{�} �, ��; ZOI�TING (o�ice use)
P .���- �w
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(Name) � i��'-�g (Phone)
(Address)
B �V*" , t� one LD �`, �iJ 1 . � b�J
� Com e
' ontact Na ) �1� (Phone)
ddress) '�1 � .1�+" . � �� �,.• S � b � s /� � J�� �d�
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch �e-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Connecn n
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V A B pROJECT COST/VALUE S
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
1 hereby certi'ty that 1 have (iimished information on this application which is to the best of my knuwlcdge true and correct. I also certi(y that I am the owncr or authonzcd agcnt for the
above-mentwn prope and that all cunstruction will conform to all existing state and local laws and wi{t proceed in accurdance with submined plans. 1 am aWare that the buildmg
official can r e t i e �se Furthermore, I hereby agee that the ttry official or a designee may enter upon the property to perform necdcd mspections.
X � C (0 3 59 2 -�' °7- /
� Signature ntractor's Lice No. Date
Permit Valuation Park Support Fee � # $
Perrr►it 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 Permit When Approved Paid R 1 t NO.
Date
Buildim� Ufticial Date
This rs to certify that the requcst in the abuve applicauon and accumpanying documents is in accordance with thc City Zoning Ordinancc and may pruceed as requcsted. Th�s ducument
when signed by the Ciry Planner cunsn[utes a[empurary Certificate of Zoning compliance and allows construction tu commence. Before uccupancy, a Ccitificate uf Occupancy must bc
issucd
Planning Director Date Special Conditions, if any
24 hour noticc for all inspections (952) 447-9850, f�x (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372