HomeMy WebLinkAboutBuilding Permit 12. 0835 •
3 ❑ ❑ 0 0 0 0 000 ro 0 > y
"g n n O to•n p o •o -C
n 0 73 73 I a 3 0DCO m m m n0
tz tri r n o 0 rn�xa o y o .0
g -+ -t 2 -d . � z o
(0 v g D N .4 n 0 O
o x o st , Z o 0
m
z 2) n 0
o ❑ ❑aoo
'� x m FYI m 31201*R-0
— N ° v nC . 0
1:1 en n1
Q x3 mx3 -0 n m
C -0 @ h z0 3 0 i m l�
O ' 02 z C C z r
Z m �ro•o O ( m� /�
A O . 1
m
tO C 8
can m n O❑❑O❑ 1
y 52 z mi
[t1 ° >
hi z iCCC> X11 3
A NI 4 -1 —
` - z
rn
p :
0 1 PR10 / .
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec . ` r1-;
c...> [\_`_,), B TEMPORARY CERTIFICATE OF ZONING COMPLIANCE a
■
AND UTILITY CONNECTION PERMIT 2 �`'' "
1. White File PERMIT NO. / Q ' `
2. Pink City / Z y CI35 ; 1 . :'t
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use) „ !
) L45 3 Appaloosa T ( HE Prior 1.a ke , •
LEGAL DESCRIPTION (office use only) s, ,
LOT BLOCK ADDITION PID
OWNER ,.-
(Name) j o h n S k o e.4 1-CX (Phone) qS 4-40 'tc 7 1
r r ,. •
(Address) 5 3 ! C CSG: 1 tOC (N ( PIO1 D C L t� i_ M S' S.� 3 1
BUILDER i „
(Company Name) SPYIY{� C �r OV)S YL�G{'IOfr SZlr✓iLes (Phone) Q�� 17 ., :W
(Contact Name) _ b 1 I1 ICI ` B k y.'D S , ` - (Phone) 9g - - 44 1 -7 I
(Address) 1t 5q LJe CcW1t AV€.vU(..i 5F, Pr('O Or 1A ILA, 1- S5'3 , ' ,
TYPE OF WORK
❑ New Construction DDeck ❑Porch XRe- Roofing ❑Re- Siding ❑Lower Level Finish 0 Fireplace
DAddition DAlteration ❑Utility Connection
CODE: DI.R.C. I.B.C. ❑ Misc:
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U PROJECT COST /VALUE $ e COO - OD
I- ; ,:, ..:;
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the `! „
above - menti. , r . operty and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building , z�,
official . revoke is per , it for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed ' spections ,
x i ir II 1 86-40)454- 5(( .
Signature Contractor's License No. Date ear
Permit Valuation 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 $ y
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ ?`
�
;
r r;!.:' r;!.:' This Application Becomes Your Building Permit When Approved Paid 7q. 7 i Rec r pt No. (p (�, d `' - ! ! i.
Date 7 -2 ./z......_ By i.,
Ai
Building Official Date a
s
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document �' .
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be .,
issued. ' ; fl il
Planning Director Date Special Conditions, if any x`•
a.
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372