HomeMy WebLinkAboutBuilding Permit #12-1352 y ❑❑� c� oaaao❑ = o o y�
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� � CITY OF PRIOR LAKE BUILDING PERM ,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
" " AND UTILITY CONNECTION PERMIT
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�. W,,;� File pERMIT NO.
z. Psa� c�ry �Z- ��� �
3. Yellow Applicant
lease e or ' t and si at bottom
ADDRESS ZONING (office use)
� � D� l�'�' � ���- S�
LEGAL DESCRIPTION (ofiice use only)
LOT BLOCK ADDITION PID
OWNER � , Q
(Name) ; �5' � 0` I .`� (Phone)
(Address) �!�i 7 OG� f� hrr.v l� C� � S� p�r 7Ji l�. i"�- L M- .y �� 7
BiJILDER i.I �� �U� �� G S�' 77� "� Ol �
(Company Name) (Phone)
(Contact Name) � (Phone)
(Address) ZC l('f�' �vG � S�G I N U,�-f'�- s� , �"�-"� S�IU
TYPE OF WORK ❑ New Construction �Deck ❑Porch ❑Re-Roofing ❑Re-Siding �Lower Level Finish ❑ Fireplace
DAddition ❑Alteration �Utility Connection
CODE: ❑I.R.C. �I.B.C. �14lisc: ��/�{ l �-✓�'^ `^' � /�L G /�' c � �'
Type of ConsL�vction: I II III IV V A B y� l� �
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE S � 6 3� �
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have fumished informaaon on tlils application wlrich is to the best of my knowledge true and conect. I also certify tl�at I am the owna or authorized a�nt for the
above-mentioned property and that all cons�uction will rnnform to a11 existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can oke ' 't for ju cause. Furth ore, I here agree that the city official or a designee may enter upon the property to perform needed inspecdons.
X - ���3s6 ��t 7 I l- 6� l 2
Signa 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 $ 7�
This Application Bernmes Yow Building Permit Wheu Approved Paid ReCei t O.
Date B
Buildin Official Date
This is to certify that the request in the above application and a«:ompanying docummts is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows conswction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director Date Specisl Conditions, if any
24 Lour notice for all inspecNons (9S2) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372