HomeMy WebLinkAboutBuilding Permit #12-399 � o❑� c� o❑ao❑ � o> Z�
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o � P�t.r �Y�'I' Q�F ��0� LA� ��J��D�l�I� �'���T, Date Rec'd
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� � �1�T� iJ'�'����"�I COI�t1�d�C'�'�Ord P���'�'
��NNES��P I, Whitc Filc �ym � ( ' y � ,p( } � 7
2. Pink City K$'�SO10'9,�� 1� �- /"'7 ,� J
l Ycllow Appticam �, �
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'—+'.� � �O�VdNC'a (office usej
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LEC'aAL. D�SCRYB'�OIV (office use onty)
LOT BLOCK ADDTTION ��
�awrn�� P�11 � `vl t�jc�...r�c��r� �ctm�e.s
(Phone)
(Address) �"'� S'Cf'G2.'!` Pr;b r l.rt. K� M� SS37 �.
BUIY,DER '
(Company Name) � �" -�7�'/ ��'1�t.C, ��/( G2$ ) (�S � --�7 97
(Phone �"
(ContactNazne) _ �Yl LS �i,t,1��S �_� 9
(Phone) _ �O '/ 97
�Aaa��s) f�59 Gl�Jco � �nu.� �br ke tiJ' ��'3z
TX'$�E OF WORK ❑ New Cons�uction ❑Deck ❑Porch ❑Re-Roofing �Re-Siding ❑Lower Lcwe! Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Connection � Misc. �+ �� ��
• CODE: ❑I.R.C. �T.�.C. PROJECT C�S2/'VALCTE g �� (SUt� .(}�
Type of Constntction: I �I YlI T.V Y A B (exctuding Iand)
Occupancy Group: A � E F H I M[ R S U
Division: I 2 3 4 5
t hrrcby certify rhat I havc furnished information on thu application which is ro thc besc of my knowledge ave and comct. 1 also certify that ! am the owncr �N authoriz�d agcnt for cht
above- roperry and [hac all construction will mnfotrn to atl cxiscing stare and local laws and will proc�ed in accordancc with submitted plans. 1 am awaxc rhat nc� buiJding
oFfida can r vokr his prrmic jusc cause. Furthcrmorc, I hereby agrcc thac tfic ciry officiai or a dcsignce may enter upon thc property co perform necdcd in pccti ns.
X W lv�'�� S /�Z
Signature Contractor's License No. Date
Perinit Valaarian Pazk Support Fee # $
Permit Fee $ SAC
# $
Plan Check Fee $ Water Meter Size 5/8' ; I"; g
State Swcharge $ Pressure Reducer $
Penalty $ Sewer/Wacer Connection Fee # g
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Pee S Builder's Deposit �
Sewer & Water Permit Fee $ Other $
Gas Fireplace Perrnit Fee $ 'E'OTAL DUE $
This Application Becomes Yous Bvilding permit W.hcm Approved Paid ei c No.
Date j /Q, / Z..._
Buildin U�cial Date
Th�s is to certify that the request in the above application and aecompanying documenu is in accordance with the City Zoning Ordinancr and may proceed as requested. 'Chis document
when signed by the Ciry Planner conscimtes a remporary Certificate of Zoniag compfianec and ailows consuuetion to rnmmence. Before ocrupancy, a Cettificate of Occupancy must bc
issued.
Pl �� g ��� ba�e Special Conditions, if any
24 hour notice for all iaspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN SS372