HomeMy WebLinkAboutBuilding Permit 13. 0412 O 2N
la
z _ E
ce u.r4 U W
° �Sg Z o Z 4
� a a a.a❑ O ¢ .ti O W W U) z Z
w o W > Q'
I,n w x
0
N p
0 O _ �� z , Z U U
-1 Z M a H 0 U O LL Q �� U c u) a i
s z ce Z_IXZZ a c
o 0 W m M aC W m u' to QG
co U a Dv n° w ° W X �
Il J w Q -. W W °G
a 23 v)a 2 U U z
000000 L.+._ o =
J
0 s Z Q p W
i- a
►- Z o
Y U p < O Y CO a
U
OZ O O w I-. a
Z <- a Z Y w la ' � q
O O z Z a N ui o Q p co 0
a� w Z �z g - 'Z o 0 o a U v
O W W z ooaNZ 0 0
a 0 0 u LLU.? rn 0 ❑❑ o)
A, 7' -\ ' tA l,.l l 1 Vf i 1,11.1‘...C. DUILLl1r il
lr r.nrkiV1 , Lime met; u
� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
"' \ t1/ AND UTILITY CONNECTION PERMIT -5' /4-.
NN Es/
I. white Pile PERMIT NO .
3. Pink City / Z
3. Yello, Applicant i
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
2_
3
ill .
C` (�
(Name) / ` t,-t (Phone) 1 1 7
(Address) ( 76 , A- t I
BUILDER
(Company Name) 6� -a.-2.1 re, - (Phone) /�
(Contact Name) C / , . vi-g,/� se,,, r
( Phone ) 6/2 6C // /
(Address) ? 7t 9 / 4/ j✓ g/ S a
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch late-Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace
❑Addition DAlteration DUtility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc:
Type of Construction: I II III IV V AB
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I s . ve 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 - mention. .rope and that . construction will confo o all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can r oke this pe mit fo .. st cause. Furthermore er agree that the city official or a designee may enter upon the property to perform needed inspect' ns.
X 6c 3 Y/ / .5" / /,_t
Signature Contractor's License No ate
Permit Valuation Park Support Fee At $
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 $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Application Becomes Your Building Permit When Approved Paid 7 7 S Re pt No. S
6
Date r /tit)
Building Official Date
This is to certify that the request m 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.
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372