HomeMy WebLinkAboutBuilding Permit #12-1338 y p p��- (� �0❑O❑ = O 0 Nn
� n n/�" O N�Z-n„„ Q � v �v�
0 0 3 vi �� Z m 7 � mp
b D o ��� 3 r�r �c; Z p y ��
t�7 r A n y R) y �Zy� Q N p�
�° � "' '' � -� m ��o z�
ro � � u, tn � z Z o �
� � ' = O Z m �
� m
� O � Z �
�
_ � � � '�
a ?o' m � � � Z O�OOO�
� X m m m m � y � ; �
O� -1 N O O � nC „s �n C
�e �' ����0 m p c
� y � � �>
�� A s ��88�� a� �
�, � = U1 ��� _ �
�„° z q m ��� � o
� ° p e�
= m
� � o � N
� y � � ooaaao N ,
� = z � �='��� ' � �
a. o c� N� � �
�° w
� � a�m W r
� m ����_ � � �
� � � o,
o � PRlp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE i� �,� L
.. � AND UTILITY CONNECTION PERMIT
U �
���xesa'�� �. Wh,�e File PERMIT NO. �Z ` �� .x. �
2. Pink Ciry + /
1 Yeliaw Applicant
Please or 'm and si at bottom
ADDRESS ZONING {otTice use)
� ° I y �. �.�.c� -�.-c.�
LEGAL DESCRIP'TION (office use only)
LOT BLOCK ADDITION PID
OWNER p �/��
(Name) �Q.�1� � `�� (Phone) ! S� � w 7 '� ���
(Addxess} J �
BUII.,DER �� ) IOS�� � � �D Z '" � � �
(Company Name) (Phone �
► � ��
(Contact Name) � � ► C ��-� (Phone)
(Address) }�Q���j ��, (� �J� � l
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
�Addition �Alteradon ❑UtilityConnection � n`0.� 3 l�� ���5 (�j/'V �f�(l��
w •v � � Q/Y�� h�� �
CODE: ❑I.R.C. ❑I.B.C. O Misc. _ ____ - -
Type of Construction: I II III N V A B pROJECT COST/VALLTE $� ( d� O�
Occupancy Group: A B E F H I M R S U (excluding land)
Divisiott: 1 2 3 4 5
1 hcreby certify that I have Cumished information un this application which is ro the best of my knowledge true and correc[. I also cectify that I am the uwncr or authonzed agcnt for thc
alwve-mennon property and th construction will conform ro all existing state and loca! laws and will proceed in accordance with submitted plans. I am aware that the bui(dmg
ufltcia! can r e this permit fo �ust use Furthermore, I hereby agree that the city official or a designee may enter upon the properry to perform necded mspecnons.
X �G ! 3�4 83 3�DC,�I�
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
P}an Check Fee $ Water Meter Size 5/S"; 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 S Other $
Gas Fireplace Permit Fee $ TOTAL DLJE $
Tlus Application Becomes Your Buiiding Pern�it Whea Approved Paid � ei t NO.
Date > 7.. B
Buildin + Utiici�l D�te
This ie to certify that thr request in the abovr appiicat�on and accumpanying documenis is in accordance with che Ciry 7A�nin� Ordinance and may protted u requcsted. Th�s dixument
when signed by the City Planner conshNtes a tempurary Certificate of Zonmg compliance and allows conm�uction tu commence. Before �xcupancy a Crruticate ��f Occupancy must br
issucd.
Planning Director Date Special Condi6ons, if any
24 hour notice for a!i inspections (9S2) 447-9R5p, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
8