HomeMy WebLinkAboutBuilding Permit #12-1178 y ❑ o� c� o�oaoa � o> Z�
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oF PR�O� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
�' � AND UTILITY CONNECTION PERMIT �� •�' Z
U �
4' t. Whiie F+�� PERMIT NO. / Z,/r�
2 ���k a�y /
3 Yellow Appliram
Pitase or rim and si at bottom
ADDRESS ZONING (otece use>
/�Gy� i��,��E � .
LEGAL DESCRIPTION (oEfice use onty)
LOT BLOCK ADDITION PID
( �� 7 !T ��S (Y�—� (Phone)
(Address)
BUII,DER
(Company Name) �N' / L'�'`�T- (Phone) �SZ ygt- � ° � `'
(Contact Name) C� u �� ^� (Phone)
(Address) �3 2— � � .Su.�si � L.r�+2e_ (� t_.�V � , r�92� /�
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch e•Roo6ng [JRe-Siding ❑Lower I.evel Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utiliry Connection
CODE: ❑I.R.C. ❑I.B.C. � Misc.
Type of Cons�uction: I II III IV V A B PROJECT COST/VALLJE S
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5 (excluding land)
! herrby certiFy t i have fumished infarmadon on this appiication which is to the besi of my know►edge true and rnrrect. I also certiry that I am the owner ur authonzed agent for the
above-ment ed roperty a d that all cunstr ction wili conform ro all existing state and local taws and wiil proceed in accardance with submittcd plans. I am awarr that thc bui(dmg
uf£icial ca evo this or t ca se. ar hereby agree that the ciry off+cial or a designee may enter upon the property to perform necded mspecnons.
x /� �-C� 39 Z 3 0 /e►��1� 2-
S' ture 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 $
Penalty $ Sewer/Water Connecrion Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Perrnit Fee $ TOTAL DUE $
This Application Becomes Your Bullding Permit Whrn Approved Paid • Recei t NO.
Date B
Buildin � UtTicial Date
Thu �s to certify that the request in the abuvr applicanon and aceumpanying documents is in accordance with the Ciry Zoning Ordinanee and may proeeed as requ�sted. 7'his dcxument
when signrd by the City Plannrr constitutrs a tempurary Certificate of Zoning compliance and alk�ws construction to commence. Before ixcupancy, a Cc7tificate of Occupancy must be
issurd.
Planning Dinector Date S ial Conditions, if any
24 hour noticc for all inspections (952) 447-985(1, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372