HomeMy WebLinkAboutBuilding Permit #12-1335 � ❑❑�, C� O ❑�DO � O D Zc�
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oF PRtp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
�, ,� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE j
� � AND UTILITY CONNECTION PERMIT (� ��� Z "
v �,
���NESD�C1' �. Wh,�e F,�e PERMIT NO.I Z•�.�7� ,
2 Pink City
3 Yelbw Applicant
Ptease or rint and si at bottora
ADDRESS ZOI�TING (uf�'ice use)
�. l' ,��,f� �L y�=
LEGAL DESCRIPTION (oflE'ice use onty)
LOT BLOCK ADDITION PID
OWNER n ��
(Name) �/� � . �-�S �,lY (Phone)
(Address) l y� ]'Yr�,� �� N,�
BUII,DER 1
(Company Name) %�_ �CfT� �-v✓f'. (Phone) � � "'�-3?4
(Cantact Name) �1,�, .�`����,�,/ (Phone)
(Address) ,�✓L� .. �
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch - oofing ❑Re-Siding ❑Lower Level Finish '❑ Firepiace
❑Addition �Alteration ❑Utility Connection
CODE: ❑I.R.C. DI.B.C. ❑ Misc.
Type of Consixuction: I II III rv 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
I h��reby certify that t have fumished infi�rmation on this application which is tv the besr of my knowlcdge hve and correct. ! also certify that f am the owncr or authimzed agcnt for the
above-mentioned properry and that all cunstruction wiil conform to ali existing stare and local laws and wiA proceed in accordance with submittcd pians. I am awam that the buiidmg
ufficial ca r just cause Furthermore, I hereby agree that the ciry official or a designee may enter upon the properry to perform necded mspecnons.
X �S � �3 ����/�2_
re - Contractor's License No. Date
Permit Val tion Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size S/8"; i"; $
State Surcharge $ Pressure Reducer $
Penaity $ 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 DL7E $
/
This Application Becoaus Your Building Pernvt When Approved Paid ' Re e" t No.
Date � (Q . < B
Buildine UtTci�l D:►te
This �s to certify that the requcst in the above applicat�on and accumpanying documenu is in accordance with the Ciry 7.��ning Ordinance an may proceed as requcsted. This dixvment
when signed by the Ciry Planner cunsiuuces a temporary Certificate of Zoning cnmpliance and alluws conswetion to commence. Before �xcupancy a Ceruticuc �if Occupancy must bc
issucd.
Planning Director Date Special Conditions, if any
24 hour notice forall inspections (9S2) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372