HomeMy WebLinkAboutBuilding Permit #12-1350 3 ❑ 0 n ❑ ❑OO❑ � O > zc�
� � �� O N Z„„�, Q � v ��
o n � ��� 3 ��c� m � m n0
b r' � m m� rn z�szoz Z t =
� r' n c� H Z � ���� � Z�
t�f $ y� --� m Z p Z o
e m �� D N o r� ��
�° o � Z-�i Z O m 7C
� � r Z � o m
� � � � N
_ ,� � v
� z 7° c c�i
00000
� � ai ° ° , n cyDm �
O x3�m=3 � c� D tn
� C � c�'�o � y� 3 Z m
n�i '� � = O r zg� � z � �
o Z � � ��� � � °
� A �
_ ' '0
m
� � o � �
`' y <
m ❑O❑�O❑
y Z � ���0(fl I � m
� Z Z
R• D � ymm3�
� C'ovv � �
� Z a��z� �
� m ��+��� � � �
r N �_ Z m
'i r �
oF PR� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT ��� � 3 ' � Z
U �
�
4�n'NESO�� I, Whice File PERMIT NO
? Pink City �� . /3�
3 Yellow Applicant
Please or 'nt and si at bottom
ADDRESS ZONING (o�►ice use�
��2-q 'rhA � . �
LEGAL DESCRIPTION (of�'ice use only)
LOT BLOCK ADDITTON PID
( ��.t �. �.ft 1U4��� (Phone)
(Address)
BUII,DER J,'�.�� /►^ P 5�•� ��So �,acC1'E� IO S I— Z 48 "1 Z21
(Company Name) , (Phone)
(Contact Name) J ��IF — ���✓�1�5°rJ (Phone)
(Address) �' �I�i�-Mt � �1 ��"t < S�t �'C�� L'o3 �ASTIn� d Whl S5a33
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch e-Roofing ❑Re-Siding ❑Lower Levei Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Conne ion
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V A B pROJECT COST/VALUE S
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
! hereby certify that I have fumished information un this application which is ro the besi of my knowledge true and correct. ( also certify that I am the owner or autharized agent for the
above-mennoned property and that all construction will conform ro aU exuting stare and local laws and will proceed in accordance with submitted ptans. I am aware that the buitdmg
uffic' ! can revoke this permit for use Furthermore, 1 hereby agree that the city official or a designee may enrer upon the propecty to perform necdcd mspcctions.
( X �7G. '� �'
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 $ `f"
i
This Apptication Bernmes Your Buiiding Pern�it When Approved Paid ei t NO.
Date .. / ( L
BuilJins Utiicinl D�te
Th�s is to certify that thr requcst in the above applicahon and accumpanying documents is in accordance with the Ciry ZAming Ordinance and may proceed ac requiKted. This document
when signed by the Ciry Planner consututes a temporary Certi6cate uf Zonmg compliancc and altows constn�ctian to commence. Befure occupancy, a Cc�ruticatt af Occupancy must bc
tcsucd.
Planning Direetor Date Special Conditions, if any
24 hour noticc for all inspections (9S2} 447-985(1, fax (9,52) 447-424i
4646 Dakota Stxeet Prior Lake, MN 55372