HomeMy WebLinkAboutBuilding Permit #12-1083 � p ❑ � (� ❑�.000❑ '� O D Zc�
p � � ��� 3 m>c�c� Z � � �O
� � � m m y r N 0 t 0�
�
� � � y- - m Z�� �. z0
C � � � (� � Z Q �
� o\ ?C a � Z m7DC
ta O � Z � m
� "� r � � 'I
_ � � �
? Z � n � OOODOCI
t:� m m m m ;�v��;v
� - x i N v v �c ��c
� o ai ; m '��'"��z � � s
� C � m � � = � = 0 4� $ -=�I O
b � 0 2 ���� � � � C
� Z � � r�� � C
� A �
= m �
x O
�, C
N < ❑000�❑ �
-�i Z o c, „-n � O� N>
a• � c ymm3� (� � m
� ��v�
� Z m���� �
� m �T��� '"
� � � - � m
r
o � PRtp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� = TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Q� ��,! �
� � AND UTILITY CONNECTION PERMIT �
�
��n'NE80�� 1. White File
, �, � PERMIT NO. �2� `��3
i Yellow Applicam
Please or rint and si n at bottorn)
ADDRESS f --�_ //� y � ,/ �� ZONING (ot�ice use)
/ �'�` �1�. � / /" / �1.�/�i /� (/ V .
LEGAL DESCRIPTION (oflP'ice use only)
LOT BLOCK ADDITION PID ��_ /$7 07Z_ �
OWNER �y�.—����
(Name) (Phone}
(Address)
BUILDER ,
(CompanyName) �N� „ � ���,o•SS �,�c�.. (Phone) °�.Sa-^£�88�OS�(
(Contact Name) `��,6�1 �L..� (Phone) t �a-- � S — 63�l�Q
(Address) �abSO — S .r�� '�
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch e-Roofing ❑Re•Siding ❑Lower Levei Finish ❑ Fireplace
❑Addition ❑Alteraaon ❑Udlity Con cti n
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III TV 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
I hereby certify that [ have tiimished information un this application which is to the best of my know4cdge true and correcc. [ also certify that t am the owncr or authonzed agent far tfic
above-mennone t aii cunsrruction w�ll c orm to all existing state and local iaws and wi11 proceed in accordance with submittcd plans. I am aware that the buildmg
ufficia! c voke this permit for ju cause Funhermore, I eby agree that the city official or a designee may enter upon the property to prrform necded mspections.
x —��—� �3 �- a t R S � d `3 -�
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; i"; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Piumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ .
This Applicallon Becomes Your Building Ptrntit When Approved Paid ' ei t NO. Z
Date 9� / . � Z
Buildine Ut�icial Date
This ts to certify that the requcsi in the atwve application and accumpanying documents is in accordance with the Ciry Zoning Ordinance and may proceed as requcseed. This di�cument
when signed by the Ciry Planner cunst�tutes a temporary Certificate of �onmg compliance and allows cansvuction ro commence. Befure �xcupancy, a Ceruticate nf Occupancy must bc
issucd.
Planning Director Date Spacial Conditions, if any
24 bour notice tor all inspections (9S2) 447-98.5p, fax (952) A47-424i
4646 Dakota Street Prior Lake, MN 55372 .