HomeMy WebLinkAboutBuilding Permit 12. 0601 O f
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2012 -06-13 22:46 ZMP_SECURITY 6514635$6 >> P 1/1 12113
F . R .. / .. 0,p CITY OF PRIOR LAKE .BUILDING PERMIT,
; - : ' t ? Date Reed
(, \ 7'EMPORARY CERTIFICATE OF' ZONING COMPLIANCE
J. - =" AND UTILITY CONNECTION PERMIT /`_ /Z-
4 '1 N S ri
iv i
t. 14t,,,, ril t:ar I
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(Plcaac type or print and sign at bottom) .t Ytnlo•+. n�y .lic rn
ADDRESS
ZONING ( nice use)
/ 7/ E3 0 c et. Cr l- C :C" St....+
LEGAL DESCRIPTION (utree use only)
LOT Oc BLOCK OO 1 ADDITION (L.' R 5-11..
PID F...11/32.00c)8 0
OvI/1vE� � � • C_' / /
(Name) .? v t r s w
(Phone) ./ 2 - '3_82 - 05 , 'G .?
(Address) /7 /sc, —Z 4.. CrRL /_ t+.,
BUILDER
(Company Dame) c;,..
(Contact Name)
(Phone) —
(Address) —
TYPE OF WORB. ❑ New Construction. ❑nccic ❑Porch
rgZe RnpTlttg ❑RC -S cling ❑L rnrct Level Finish ❑ Put la
P ce
❑Addition ❑A1T4ralion
❑Utility Connection
CODE; QI.R.C. 01.B.C.
0 ?Qtse,
Type of Construction: 1 11 11I IY V A g
Occupancy Group: A I3 E F H I M R S U PROJECT COST/VALUE $ ] c) -
Division; 1 2 3 4 ;
excluding land)
I hereby certify that 1 hose furnished ir:lort:tatim on this application which is to the pest of o,y lmnwtcdEC rntc and conceit I also certify that Ian: the owne, or au d :m r rd asciu ti'- ehc
alwve.mertio,t prcpcny and that aU coasuuoion wilt conhkmr to alt existing state and 1nzli laws and will procie ! in aceortance with nibmi:ad plans.
t :cev.,kc ' per A brtwm, i',acby agree that the c lty oifcialitadeer ter ,n: enteru upon r<> I;totawarethatthet.u'I ;ling
� Y P l epetty to rciiorm tter.;ard iasprcticns.
...........—,'#'- Ar /e 1 /
Signature _ iiNc D 2•v :x—
Contractor's License No. f TS ate
Peer pit Valuation Park Support tee #
Permit Fee S SAC
Plan Check Fee S Water Mete; Size 5/8"; I";
$
State Surcharge $ Pressure Reducer
S i
Penalty- $ Sewer /Water (onnetx ii
5
Plumbing Permit Fee $ Water Tower Fee
Mechanical Permit Fee $ Builder's Deposit -
Sevier & Water Permit Fee S I Other
f
Gas Fireplace Permit Per $ TOTAL DOTE
This Application Bttnntes Your Building P Paid Date I
omit Vann Approved �ir_
Q 37`_ No.
13udiingO1l;cist Dine J
Thi. Is to e::tt:y that the tet:cest in the above application and atvompa.1yinh dxuincnir is in accordance with the City Zoning Ordinance and nay cee:i a: req This
when signed by the City Flanrrr constiruer• a temporary• Ccnitic'ite of Zoair, compliance and alums cdnsttuaiun ID eaturnenec. Before 0.^cupr y,a Certifica arOctupanty must c be
issued.
[ Pkn-tmg Director bate
Special ('ondltitme, if
24 htnrr notice for till inspections (752) 449!9B50, [,t,>, (952} 43 7-4245
4646 Dakota Street S,P Prior Lake, Minnesota 55372