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eJTY'OFPRlOR I ,A KE.
DEMOLITION PERl\fIT
t2e - (2~
Date Rec' d
I PERMIT NO. IJ 0 ~ 0'2510
ADDRESS
~{) J- 7
ZONlNG (office use)
LAAle .AlL
LEGAL DESCRIPTION (office use only)
LOT' BLOCK 9 ADDITION [A/llZ,AGE- l-hiLf ;s.,
#; nOltJ
Pill
OWNER
(Name)
VAN
,Ie ffUL-TZC
LA;
f~
(Phone) 95) - <llfO - '10(-/0
Celt 6'2- b ~ -q 30 f
(Address) L.{ 3:;...
CONTRACTOR
(Company Name)
(Contact Name)
(Address)
5tLF
(Phone)
(Phone)
Use of Building:
INTERNATIONAL BUILDING CODE
Type of Construction: I II m IV
Occupancy Group: A B E F H I
Division: 1 2 3
V A B
M R S U
4 5
D MPCA NOTIFICATION OF INTENT TO PERFORM A DEMOLmON
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-mentioned property 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 official can revoke this permit for just cause. Furthermore,
I hereby agree that jl\e city official or a si ee en~~r upon the property to perform needed inspections'~h
t:J ~ ~ 1'6 /) {,
S~~re ' I Dare
I METRO (MCES) SAC UNIT
DETERMINATION
Building Official
Date
This is to certifY that the request in the above application and accompanying docwnents is in accordance with the City Zoning Ordinance and may proceed as requested.
Planning Director
Date
Special Conditions. if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue, Prior Lake, Minnesota 55372