HomeMy WebLinkAboutBuilding Permit #12-0812 y ❑� C� 0�0000 = O � y�
� � �� O H�,Z„„„ p � v �
p n � ��� 3 r�r �c m � m n,�i
� r • � m� m y r D Z 0 Z � N ��
�e . . D Z � 0��� Z �
C � �� (n � Z Z � ��
� o � D O m 7�C
� O r Z �
-� � � �
_ � � �o
� Z � n A ❑❑O❑❑❑
'� x m m m 3 ��'� ; �
,O� � � G O nC �nC
� x3 mx3 � n cn
� O N m ������ m � �
C � u � =� � 3 Z m
b � 0 2 r Z�� � � � c
O Z � � � ` r � � � G
� A �
= m
� C � �
y m ❑❑❑❑O❑ I�' '�
y g � ���nt I O �
� D c� ymm3c 0� �'"
v r�y�� N
� D m��so N 1
� Z >
� m �, r �
� �z � m
D
oF PR��� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,, � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
� � AND UTILITY CONNECTION PERMIT
U �
��A'NES��� I. White File pERMIT NO.
2. Pink City �� _ �/L
3 Yellow Applitan�
Please or rint and si at bottom)
ADDRESS � r' � � ����` ` � ` r n �� � 1 � , ZONING (otTice use)
�,.
J � ��
LEGAL DESCRIPTION (oflPice use only)
LOT BLOCK ADDITION PID
OWNER ��. � \„��`.Y (Phone) �' �" D UV ' `7Q /�
(Name) � V( ) ��,
(Address) J �'�,
BUII.,DER � �- ) �I'"�t�7 "y7 ��
(Company Name) K�-�� i'�..� �� �r�[�► SQ��7 (Phone
(Contact Name) (Phone)
(Address) �9 � , � � G . � ��� ' hU � �t'� 'N � �)
TYPE OF W�RK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofin ❑Re-Siding ❑Lower LEve F�i i��s .❑` Fire� l�ac(� r
❑Addition ❑Alteration ❑Utility Connection �`Q,� � � � r��^-' cS w� ��
CODE: ❑I.R.C. ❑I.B.C. 0 M�sc. �
Type of Construction: I II III N V A B pROJECT COST/VALLTE $ ��(��
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5 (excluding land)
1 hereb certify that [ have fumished information on this application which is to the best uf my knowlcdge true and correct. I also certify that I am the owner or authonzed agent for thc
abov - ennoned property that all construction wiU conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
offici can revoke this pe it r just cause. Furthermore, I hereby agree that the ciry oiEicial or a designee may enrer upon the property to peri'orm nreded ms ectiuns.
� I c,� � U.J L
Signature Contractor's License No. D
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 DLTE $
This Application Becomes Your Building Pern�it When Approved Paid ReCei t o
Date ' � Z- B
BuilJine Ufticial Date
This �s to crrtify that the requcst in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requcsted. Th�s ducument
when signed by the City Planner consntutes a temporary Certiflcate of Zoning compliance and allows constniction tu commence. Before uccupancy, a Ceruficare of Occupancy must be
issucd
Planning Director Date Special Conditions, if any
24 hour noticc for all inspections (9S2) 447-9RS0, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372