HomeMy WebLinkAboutBuilding Permit #12-1048 � ❑ ❑ � (� O ❑00❑ � O D Zn
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��� �P � CITY OF PRIOR LAI� BUII,DING PERMIT, Date Rec d
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
" � ` AND UTILITY CONNECTION PERMIT
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f �'NES��
,. ww�e File pERMIT NO. I L'�D��/
2. Pink Ciry
. 3. Yeilow Applicant
ease or ' t and s' at bottom
ADDRESS ' ZONING cott'ice use)
l `7�1� �> � �
LEGAL DESCRIPTION (ofl['ice use only)
LOT BLOCK ADDITION PID
OWNER � / C
(Name) � ti � � � � �M ��' k 12 C... �1 (Phone) la ( �' Y � " a �. [ �
(Address) � `
BUII.,DER ('�. (t S �^�
(Company Name) J L�+-��.•zsL�_,�� � (Phone) � 7 "-'� ���
(Contact Name) � ��- (Phone) �15�^a7'7^ l 4 �/
(Address) �`7S � C yC �._.�.SZS c a � k c` t'h /� S 3 4
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
�Addition �Alteration DUtility Connection
CODE: ❑I.R.C. �I.B.C. �Iisc: 1! �-e,.,,�A ( f+.�l'�, � � � n
Type of Construction I II III IV V A B J m
Occupa�cy Group: A B E F H I M R S U PBOJECT COST/VALiJE S � 9�3
Division: 1 2 3 4 5 (excluding land)
I 6ereby certify that I have fUmished informadon on this applicauon which is to the best of my knowledge true and corred. I also certify that I am the owner or authoriud agent for the
above-mentioned propecty and that all rnnsauction will wnform to all existing stau and local laws and will proceed in accordance with submitted plans. I azn aware that We building
official can revoke Wis pemti[ for just cause. Furthermore, I hereby agee that the city official or a desigrtee may enter upon the pcoperty to perform needed inspections.
� � _ �t� �-... 9.�. �. � - f�c- a 3 9�� �i � �f .'f �
x -
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Watex 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 $
Sewet & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DiJE $' .��
This Application Bernmes Yo�a Building Permit When Approved P3id ReCei t
Date y. B
Buildin Official Date
This is to certify that t6e request in the above applicadon and accompanying documents is in accordance wiW the City Zoning Ordinance and may proceed as requesced. This document
when signed by the City Planner consdtutes a temporary Certificate of Zoning mmpliance and allows conswction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director Date Special Cond'ttions, if say
24 how notice for all inspections (952) 447-9850, faa (952) 447-4245
4646 Dskota Street S.E., Prior Leke, Mianesota 55372