HomeMy WebLinkAboutBuilding Permit #12-0973 3 ❑❑�. C� 0��00❑ = O � ZA
� � � 3 U! �1 N '�I p �I = � � m �
p y o ��� .� 3 ��c3zS m � m �,�i
� � � m m y � Rt y SzyZ O tn O�
t� � "� y� �� - m Z�p� ZO
C
ro� �� , cn � Z o �
� 'n �> O � z � . Z m 7C
m
� � ��o� ���
���
� Z °� � � oaaaoo -_.
o� z v o � "'c v \
�>m
� o�� m � �' �=�o��z m p � i
c�, �o � �� g � � � Qo m
� n � � r ��� � � C
t�i� � 0 2 � � 2 - �
�° z � m d(` ��� � ,.1� v
� _ �m � � U�
� o � � . cr � _...
0
� N � �ooaooq ^� o
� = Z C� ����� \ — �
� v � � ��� �
� �
� n >mm�� �
� m �„� � �
� �� � � �
oF �R� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
� � AND UTILITY CONNECTION PERMIT
U �
���'NES��h 1. White File
Z�;�. �„ PERMIT NO. 1 L� U I��j
3 Yellow Applitant _
Please or rint and si at bottom
ADDRESS ZONING (otrice use>
,:,�h o,rl�' �
LEGAL DESCRIPTION (oflFice use only)
LOT BLOCK ADDITION PID
OWNER
(Name) �� � I (Phone)
(Address) �
BUII�DER
(Company Name) fM ������r���/o✓i (Phone) �/�� ya 3 - S�a9�
(Contact Name) /�►�1 ay� vba (Phone)
(Address) � r �. �- �
TYPE OF WORK ❑ New Consauction �Deck ❑Porch e-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Uplity Conne tion
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V A B m °`
PROJECT COST/VALUE $ �d �
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 S
1 hereby certify that I have fumished information un this application which is ta the besc of my knowlcdge trae and correct. i atso certify that 1 am the owner or authonzed agent for the
above-mennoned propetty and that all construetion wiA conform to aU exuting state and tocal laws and will proceed in accordance with submitted ptans. t am awaze that the build►ng
ufficial can revoke ' permit for t cause. Funhermore, I hereby agree that the ciry officiai or a designee may enter upon the property to perform necded mspe:ctions.
x G �L' Coy��SS3 g_aZ7—/p'
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ Pressure Reducer $
Penaity $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanicai Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee S Other $
Gas Fireplace Perrnit Fee $ TOTAL DUE $ 9. 7�"
This Application Becomes Yoor Building Pernut When Approved Paid Recei
Date Z B
Buildin � Utiicial Dnte
This �s to certify that thr requcst in the above appticanon and accumpanying dexumencs u in accurdance with the City Zoning Ordinancc and rruiy proceeA as rcqu�sced. Thrs dixumrnt
when signed by the City Planner consututes a tempurary Certi6ea[e uf Zoning compllanee and alle�ws canstruction to commence. Before cueupancy, 1 C�tititicate �if Occupancy must be
issucd.
Planning Director Date Special Conditions, if any
24 hour noticc for aii inspections (9S2y 447-985(i, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372