HomeMy WebLinkAboutBuilding Permit #12-0982 y ❑❑�. C� ❑'��ODO = O o yn
� � �� O u,�,=�,,,,� p � v v�
0o Z
p D a �� A 3 r��c3z� m � y ��
b r� m m � rn'z SZOZ Z tn �
c� �
� � A � � � m ��={ o Z—
;+ v, N � z Z r Z p�
m �
~ o _ Z � Z � m�
� m
M O D Z �
� -� r � � �
�, o � � �
� m � o 0 0 ❑❑DOO❑
'� x m m m �( m��'�
o� -a N v v \ nc .,�.��c �
� x3�mx3 � c� � tn
� C � co � • yc 3 = � m
b n Cj O r�n00 � � � C
� � o z Z�c �c z r
�� m �v� � � v
z
� A � ,�
= m
x c o N —4
y m ❑❑❑❑�❑ ,�
� Z z >��0� �
�' G � �' N � m
� Z m��s�
y n Dmm��
� m ��t� r ;
� � � m
oF rRi CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� �. TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
� � AND UTILITY CONNECTION PERMIT
U �
y � NE8 �* I. Whi�e File (/
H o � ���� c��,. PERMIT NO. /r� —���3 �'
3 Yellaw Applicant
Piease or rint and si at bottom
ADDRESS ZONING �o�«� �se>
I y32 �r L t� E
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER /�
(Name) ��X1G� �� ��. (Phone) I�SZ� y�3 ^ 9 �ZZ
(Address) ) y 4 3 Z In ,r �.,.v� `IV �
BUII,DER
(Company Name) � 0. Lll � �i (Phone) � � 7G� "�q � �'1
(Contact Name) � C a (Phone) y S Z- Z� Z' 3��i Z
(Address) Z � �a, Z N. � 5 11
TYPE OF WORK ❑ New Consvuction ❑Deck ❑Porch �Roofing ❑Re-Siding ❑Lower Level Finish ❑ Firep(ace
❑Addition DAlteration ❑Udiity ConneCtion
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III N V A B
Occupancy Group: A B E F H I M R S U PROJECT COST/VALIJE $
Division: 1 2 3 4 5
(excluding land)
I hereby certity that [ have fumished information on this appiication which is to the bes[ uf my know►edge true and correct. I also ce�tiFy that I am the owner or author�zed agent for the
above-mennoned propetty and t atl construction will conform to ail existing state and local laws and will proceed in accordance with submitted plans. I am awaze that the buiidmg
utl'icial can rev t's per it fo us ause Fu ermore, I hereby agree that the ciry official or a designee may enter upon the property to pcn�Porm necded iacpections.
X
ature 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 # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Perrnit Fee $ TOTAL DUE $ � 7
This Appticarion Bernmes Your Bui[dittg Permit Whrn Approved Paid Recei N
Date J� B
Buildine Utlicial Dnte
T'h�s ic to eertify that thr requcs[ in the above applicat�nn and accumpanying documents is in accordance with the Ciry Z.�ming Ordinanec and may proceed as requ�s[ed. This dixument
when signrd by the Ciry Planner cunsututes a tem{wrary Certifieate of Zoning compliance and allows cunstruction to commence. Before �xcupancy, a Cctit�t'icah of Occupancy must be
issucd.
Planning Director Date Special Conditions, if any
24 hour notice for all inspections {9S2) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
' . . ' . . .. ,. .. i . . . . . . .. .. � � . t: � -- " -- .
f