HomeMy WebLinkAboutBuilding Permit #12-1124 g ❑ C� �0�00 'o O D ZC>
� � � � O u, Z „„�, p p �
n � � � � � 3 ���'� m � m n0
b D � � � � 3 r _ � y ��
� � m y C m y S=oZ � v, 0 �
1�0 ti ' N m ��z� Z � r
� Z � Q�
� � D � O ={ D
�, � - � � = m m
� � � 7��0 � � �
� � � � �
� "' °� � � 00000❑
''� m m m - m�
4° � t� � 1� =��m=�C � n � t�
� � � � � Z � = S � � � O G
� 88 � �
� � ; z � r ��� � _ �
o Z� T ��� a � v
� � � N
= m
� c � ' `� �
y o00000 �
� D � � ���;� � � �
� °<, _ ms��� N \
� n N >_mm��
� m . �-�� �
E ,�
�� �
oF Qtt� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,, � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Q��Z
^ � AND UTILITY CONNECTION PERMIT � ` �
U �
�
y�NN6S��� t. White File
z �,�� c�� PERMIT NO. 1 Z//Z4�
3 Yellnw Applicant
Please or rint and si at bottom
ADDRESS ZOIVING (ot�'ice use)
I � �� /v
LEGAL DESCRII'TION (oti'ice use only)
LOT BLOCK ADDITION PID
OWNER � //
(Name) (Phone) `7.'7 � '" Y"[ � '" �,�q �
�
(Address)
BUII,DER .�^ ,/ �
(Company Name) �('�.��� ���,�, C Ir � L (�° � ..4-iU (% (Phone) �/� �-`!� � ���� l �
(Contact Name) �'/� � L ��119A� °i� � (Phone) � a �/tl _
(Address) , � Y
TYPE �F WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roo6ng -Siding ❑Lower Level Finish ❑ Fireplace
❑Addidon �Alteration ❑Udlity Connection � t �
N �
CODE. �I.R.C. []I.B.C. O Misc.
Type of Canstruction: I II III N V A B PROJECT COST/VALTJE S
Occupancy Gronp: A B E F H I M R S U
(excinding land)
Division: 1 2 3 4 5
I hereby certiCy that [ have fumished inknmation on this application which is to che best of my knowledgc tnie and correct. I also certify thac 1 am the owner or author�zed agent for the
above-mentioned property and that all construction will conform to aA existing state and tocal laws and wiil praceed in accordance with submitted plans. I am awarc that the build�ng
official can revoke this permit for just cause. Funhermore. I hereby agree that the c�ty official or a designee may enter upon the properry to perform necded mspections. � V_
X �C�C2� �-- ' � Z
Signature Contractor's License No. Da�e
Permit Vatuation 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 S
Gas Fireplace Permit Fee $ TOTA.L DUE $
This Application Becomes Your Building Pemtit When Approved Paid ReC t NO. 7
Date $, l B
Buildine Utiicial Date
Thu u to eertify that the requcsc in the abuve appiicauon and accumpanying documents is inaccurdance with the Ciry Zoning Ordinance and may proceeA as requcsted. Th�s dixvment
wh��n signed by the City Ptanner cuns[i[utes a tempurary Certifieaze of Zoning cvmplianee a�d aAc3ws constsuccion to eommence. Before �xcupancy, a C�ntificam of Occupancy must be
issucd.
Planning Director Date Special Conditions, if any
24 hour noticc for all inspections (9S2) 447-9R.50, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
_ . _ _ ' . _ _ . . _ _ . . .. . . _ . . . . _ .�. 2