HomeMy WebLinkAboutBuilding Permit #12-1082 y ❑ p''�_ (� O��OO❑ = O � y�
� � �� O u,„Z�n„�, p � v �v
0 0 3 ��vi �� z m � mp
b D o ��� 3 ��3z� Z � y ��
'�+ r ��-1 - > Z � � +nD� � y Z�
io � �> i v�i � z Z
S � ° � > o 0 0 ��
o _. Z � = m �
� � m
Z �o � v �
� - i „ v v
x
� _ � � � ❑oaOO❑ -
O x ; z v v m c N � ; c �
Dm
�e+ � cn i3�m=3 � c� � v�
z � � ao 0o m �
� c� � �j�, � z�s 3 z � m
' � v
b n n O ��� � r � � C
� � � � � yCC Z m
o z� m ��� � v
� A � ��''
= m �
� c �
� m ❑a❑ao❑ � �' �
�
� Z z >��o�" � � � '
� G � �v�v� � ` m
1�,
D m���p �
l� A D I 1�ff �� �
,� �f1 .'0 'f1 ,'p �. .�
.� N �- _ , ;
-� r - � C m
oF PR��� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
� � AND UTILITY CONNECTION PERMIT
U �
�� NES �r I. White File
'� o Z ���� c �� y PERMIT NO. r��l� S/L
± Yellow Applicanl
Ptease or rint and si at bottom)
ADDRESS � ZONING (uft'iee use>
w� o�a C�1 �,�3; ��--�.� �-� � ���.ss 3
LEGAL DESCRIPTION (oflfice use only)
LC�T BLOCK ADDITION PID
OWNER
(Name) �,�� �� S (Phone)
(Address) /�� � � (��lit� �, �'"' •�.� � �
BUII.DER r S� yl- S E=—
(Company Name) T�✓� i y S (Phone)
(Contact Name) ° L (Phone) � `3 � ' � S 1 'Z - �
(Address) _ � �c� � 7 G-�, . �� p /� � ��� � �
TYPE OF WORK ❑ New Consauction ❑Deck ❑Porch �.e-Roofing ❑Re-Siding ❑Lower Levei Finish ❑ Fireptace
❑Addition ❑Alteration ❑Unlity Connec�non �� � �`�
CODE: ❑I.R.C. ❑I.$.C. ❑ Misc.
Type of Construction: I II III N V A B pROJECT COST/VALLTE S
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 Z 3 4 5
i hereby certify that i have fumished �rmation un this appiication which is to the best of my knuwledge mue and correcc. i atso certify that I am the owner or autharized agrnt for thc
above-menu ed proprrty and t cunstriiction wii! conform ro all existing state and local laws and wiil proceed in accordance with submitted plans. I am awaze that the buitdmg
ufficial can voke this just cau e Fu � ete-�hereby agree that the ciry ofFciai ar a designee may enter upon the property to perform nerdcd mspectiuns.
( �'r - ��r�l �
X
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 $
Penalty $ SewerlWater Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ _ 7�I
This Application Becomcs Your Building Pernut When Approved Paid Recei t NO
Date B
Buiidin � Ufficia) Date
This is to certify that thr request in the alwve appiication and accompanying documents is in accordance with the City ZAming Ordinance and may proceed ac requcsted. This dimument
when signed by the City Ptanner conshmtes a temporary Certificate uP Zoning compliance and alluws canstruction w cammence. Befure �xeupancy, a Cernticue ��f Occupancy must be
icsued.
Planning Director Date Special Conditions, if any
24 hour noticc for afl inspections (9S2} 447-98St1, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372