HomeMy WebLinkAboutBuilding Permit #12-0323 S O`I�' O �" C) ��=00❑ O � o ��
� � � N �1 — �1 'ff �I y
b D � ��� 3 m ��3z� Z � c .
� � � m m y • m N �zDZ O N O�
�e � � s Z � ���+� z�
ro � � n �' r c'�n � z Z p�
� � o � Z ��
� . n D o mm
� o � Z �
� � � {
_ ,� v v
� m °� o o Oaaoo❑
'� m m m m � '��
� � a, ° ° n� "
� Ae ���� m p c
C � � � Z c = i = O�� 3 Z m
b � � o ��,go ��� °
�, � o z . z�� z r
o z � � �'°� o v
� A �
= m
� O n �
� C � ^
N m ❑�Oa00 ' � o
y Z � ? �T��� � �
� G � r���� (� m
D m�5�p �
e�i� � . Dmm�'1
� m ��n� �
� yZ = m
-� r G)
� 7 J �s
o � prcf CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
� � AND UTILITY CONNECTION PERMIT
U �r
M��'NES��P I White File
2. Pink �,� PERMIT NO. � Z. 3�
3 Yellow Applicant
(Please e or rint and si n at bottom)
ADDRESS ZONING (o��ce use)
`�l a 7�rUc.l h � 1 Vc� l��
LEGAL DESCRIPTION (off'ice use only)
LOT BLOCK ADDITION PID
o�R,. �,(� - � q5"� .� - �� �
(Name) � �� 1 �u V`�u !�-�/Z-tG� (Phone) �
(Address) � �(� � /�f �, �'J�- / ��/� J�S� �
BUII,DER // l_
(CompanyName) � �� (Phone) ���– ���' `° 7�
(Contact Name) (Phone)
(Address) � � � � � � ��
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Leve� Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. �Misc. 1 ��t/�'Xf�'•�l�s' � l� (��
Type of Construction: I II III IV V A B pROJECT COST/VALU� $ ����1 'Y��w
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5 (exciuding land)
I hereby certify ihat I have fi�mished information on this application which is to the best of my knowledge m�e and correct. I also certify th�t I am the owner or authorized agent for the
above-ment�oned properry and that aU construction will conform ro all existing state and local laws and will proceed in accordance with submitted plans. I am aware that thc building
official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform necded mspections.
X �v� �r�;�� �r���7y� �-/� �oZ
,:
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 $ Sewer/Water 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 $
This Application Becomes Your Building Permit Whrn Approved Paid `—� Recei o. �
Date - �. L B
Buildin Utlicial Date
This is to certify that the request in the above application and accompanying documents is in accordance with the Ciry Zuning Ordinance and may proceed as requcsted. This documenc
when signed by the Ciry Planner mnstitutes a temporary Certi6cate of Zoning compliance and allows construction to commence. Before occupancy, a CciYificate of Occupancy must be
issued.
Planning Director Date Special Conditions, if any
24 hour notice tor ali inspections (9S2) 447-9850, fax (9S2) 447-4245
4646 Dakota Street Prior Lake, MN 55372
�',) ,) (�0'3) $����( ( +--'+-+(rd( (�,��"3�rd) ,$Z£) •++'�•/- ()�'OOZ/�( (,�a#iS� �iSu i i �� iP'�'�