HomeMy WebLinkAboutBuilding Permit #11-0885 y p❑� C� O� � O O O � O D Z c�
c� c� O u,„=-n„„ z p � ° v ��
n p D o ��� 3 ��c3zo m � y n,�i
� �� c "' i c m i y �' m N� c�i > c � N ��
ro ,� ,� � � m � z —
� n � N � = Z ��
� t� 0 A Z R n l �
O Z � �
m
M o � Z �
� � r p �
_ �1 � �
� m °� o � oaoaoo �
'� m m m m mr�-�'��� �
o� � y v o , �c '�c
� �e Z � � ��7o� m p c
C � c'o � yc Z i p = g�c = i 3 � m
9° p � p r�0 � a . C
��'1 � � � �CC = �
� _ � m r - �v � � o
� � 70 `
= m
"Z' C n � ' �
O
� N � OOOODO `+`�
Z � � �
� 0 � ����� �
� n >�m��
� m �„� �
.. �� E
oF PRlp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
y ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Gi
� � AND UTILITY CONNECTION PERMIT <' 7 ' l/
�
'djN I. White File • ��
2 �;�, � PERMIT NO.
3 Yellow Applicant
r rint and si at bottom
ADDRESS ZONING (ott'ice use)
�� o `7 Y-c- U � �-c ( � V 6i � �� I , L
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER �� �� (Phone)
(Address)
BUII.D ny Name) �-'� �,t� s��"T� hone) �,52�� ��Oc7
ontact Name ��`�>' S� � (Phone)
`7 �((o L� � l/� -� f o�3 L�-�1/� �� � 1�-t �V �� �f
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch -Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition �Alteration ❑Urility Conn tion
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III N V A B pROJECT COST/VALUE S
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that i have (umished information on this application which is to the best uf my knuwlcdge true and correct. I also certify that I am the uwncr or authonzed agent for the
above-mennoned property and that all cunsnuct n will conform to all existing state and local laws and wili proceed in accordance with submitted plans. [ am aware that the buildmg
official can revoke this permit for just cause. Fu ermore, I hereby agree that the c�ry official or a designee may enter upon the property ro perform needed inspections.
X
Signatu o tractor's License Date /
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 $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Application Becomes Your Building Petmit When Approved Paid Re i t NO.
Date � �
Buildin � Ufticial Date
Th�s is to certify that the requcst in the abuve applicahon and accumpanying documents is in accordance with the City Zuning O�dinantt and may pr�ceed as requcsted. Th�s document
when signed by the City Planner constuutes a tempurary Certificate uf Zoning compliance and allows construction to commence. Befure uccupancy, a Cc�t�ficate uf Occupancy must be
issucd.
Planning Director Date Special Condidons, if any
24 hour noticc for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372