HomeMy WebLinkAboutBuilding Permit #12-1071 y O O� C� ❑ODO❑❑ � O A =c�
c� � o 0 0 3 y ZN�� T z � � m�
� S1 � � m m O
° � ° � � � � m z�5zo= z � y ��
� � � � � � - m ���� o Z o
.� D O Z
Z
C � . D � N � Z �S
_ -�i m m
� o a Z � P
� � . F v � f �'
� ,� � v
'�e °� � � � 0000aa �
o � m m ;��'���
�° ' t � � � � =3�r��i =3 �p p t�
�
� e m � ` � � 'G �3 O n
b � o = � ��gg ��� g
� �' c , a �` t ��� o �
° z � m .� r • p
� = n�i
� � � � —
o -
� y � �0 ❑aooaq --
A. 3 ' � � y�m�Gi ` � ,
v �
� D � ��5�� p �
� m � �, � N �
� � m
� � �
�
o � PR��� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
.. � AND UTILITY CONNECTION PERMIT �" � 7 ' ��
� �
~��'NBS��� 1. Whi�e File
2 �,�, �,� PERMIT NO. �� ,�d 7/
3 Yellow Applitant
Please or rint and si at bottom
ADDRESS ZOI�TING (o�t'ice use>
a o 6 ,.��- F� k�- c� ��W- �..��.. �.,� s s� �.2
LEGAL DESCRIPTION (office use onty)
LOT BLOCK ADDITION PID
OWNER
(Name) � � � ��- '' 3 �� (Phone)
(Address) � �. � �—
BLTII,DER / t � ?
(CompanyName) L_: F�--��+� ��^►� �. LI-. L (Phone) 76 ��'`� 3 5r' 3/ 3
(Contact Name} � �tf�� �.., • _ � �z .� c � (Phone)
{Acldress) y yS p � �-,�-,,,� .u.-. .,.� S'so �c
TYPE (�F WORK ❑ New Construction ❑Deck ❑Porch Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition QAlteration ❑Utility Con cti
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U pROJECT COST/VALIJE S
Division: 1 Z 3 4 5
(exciuding land)
1 hereby crrtify that [ have fumished inf�rmation on this appiication which is to the best of my know►edge ave and correct. [ atsu certi(y that 1 am the owner or authonzed agrnt for the
above-ment�oned property and that aU cunstruction wiii wnform to atl existing state and local laws and wiii proceed in aceordance with submitted pians. I am awaze that the buildmg
ufficia! can revoke this permit far just cause. Furthermare, I hereby agree that the ciry official or a designee may enrer upon the property to pcK�form necded iarpections.
X �,.� �c 4�c1�s� y-/7-i�
Signature Contractor's L.icense No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/$"; 1"; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Buiider's Deposit �
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Applicadon Becomes Your Building Perntit When Approved Paid ` eCei t NO.
Date . � �?_ <
Bui{din � (31�icial p�te
Tfiu is ta certiFy that thr requcst in the above applicanon and aceompanying documents is in accordance with the City Z<ming Ordinance and may proceed as requ�sted. T'his deuument
when signrd by the City PLinner consntutes a temporary Certificate of Zonin� compliance and aliuws canstruction to commence. Before occupancy, a Ccrnficare of Occupancy must be
issucd.
Planning Direcwr Date Special Condidons, if any
24 hour noticc [or all inspections (RS2) 447-4850, fax (952j 447-4245
4646 Dakota Street Prior Lake, MN 55372