HomeMy WebLinkAboutBuilding Permit #12-1482 � ❑❑ p C� 0�,0000 � O > Zc�
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o � px� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,, � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
� x AND UTILITY CONNECTION PERMIT
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� �,�, c ,, Y PERMIT NO. I.Z _ I���
3 Yeliaw Applieant �
Please or rint and si at bottom
ADDRESS ZONING c���� USe>
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LEGAL DESCRIPTION (of�'ice use only)
LOT BLOCK ADDITION PID
owivER � .° l�.c�,.�
(Name) � �^ -t IJ� 9�� (Phone) ,� /�� 8� �� G �' S �i
(Address) /S 3��J G.�-'� t.�S �/YC.�a /I/. Gv• ����/Z- L�-/�t �'y''.
BUII,DER J
(Company Name) � ��'^�^�� �X'T-Gl ' ��J (Phone)
(Contact Name) /�LC �' /"�j'�c�t S (Phone) G/'.� �� 1 0 3`�`/
(Address) /.1.t � `7 �• C6 //� �- ..Sa� '� �. ��-/'••� Sv � L Lt /�l�•v S S'� 3 � �
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-RooHng e-Siding ❑Lower L.evel Finish ❑ Firepiace
❑AddiUOn ❑Alteradon ❑Udlity Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III N V A B '7 �00 ° U
PROJECT COST/VALUE S �
Occupancy Gronp: A B E F H I M R S U (exciuding land)
Division: 1 Z 3 4 5
I ht�reby certify that [ have fumished information on this app6cation which is to the best uf my knowicdge true and conect. I also ceniry thac 1 am the owncr or authon2ed agent For the
above-menhoned proper[y and th [ consnuction wili orm to aU existing stace and tocai taws and will proceed in accordance wi[h submitted ptans. I am awaze that the buildmg
ufficiai can revuke this per st s Furth re, I hereby agree that the city officiat or a designee may enter upon the property to perform necded inspectiuns.
X ,BC (03 S YD 3 /.zll4�/�
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/WaterConnectionFee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Apptication Becomes Your Building Pemtit When Approved Paid Recei t No.
Date -1a _ 1'Y B �
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Buildine Ut�icial Date
This is to certify that the requcst in [he above applicanon and accumpanying documents is in acmrdance with the Ciry Zoning Ordinancc and may proceed as requcsted. This document
when signed by the Ciry Planner consntutes a temporary Certificate uf Zoning compliance a�d aUows consmuction tu commence. Beforr �xcupancy, a Ceruticate uf Occupancy must be
issucd.
Planning Director Date Special Conditions, if any
24 hour notice for ali inspections (952) 447-985(1, fax (952) 447-424,5
4646 Dakota Street Prior Lake, MN 55372