HomeMy WebLinkAboutBuilding Permit #12-0781 N ❑❑ O (7 O�(00�0 = O 0 N�?
n n � o o p � �� m � m m 0
b D o ��� 3 m r c 3z-i � y .
� � m � y m N �ZSZ p m ��
� � -��i m ��� Z �
O p
� ;� N N � Z Z O�
� .� �
ti �
�
� o � y O = m �
t� O D A � � m
� Z 70
�
�
a � o � � yl�
s
�e i � n n � O❑❑❑O❑
t� m m m m ;vrn�;v
�
� - y O O nC �nG
S3�R1S� '9 n N
� � � � � t , y� 3 � m
� � o ° � �zg� � Z ' c
� Z � m � ��� � G
�' A O ,
� = m � -�
� C � N � �
y m �' ❑❑O❑�❑ �
� Z = � D�pO� ��,, � �
� � � r � � � � � m
� n Dmm��
� r" �o"� � s
�� � m
oF rR� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,� ,� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
� x AND UTILITY CONNECTION PERMIT
U �
�►jNNES�4� I. White File pERMIT NO. //
2. Pink City / Z �"� ( /
3 Yellow Applicant IJ
Please or rint and si at bottom
ADDRESS ZOI�TING co�f'icc use�
y�-c�a �a��� c,����
LEGAL DESCRIPTION (ofiice use onty)
LOT BLOCK ADDITION PID
�aWNER �ob � r � an�- (Phone) �JO�' / � l(J� /Q�
/\
(Address)
BUII.DER � /— U 1
(Company Name) Tlt�[1-�,LY� �y ������ (Phone) ��' �(�J7'� T ��
(Contact Name) (Phone)
(Address) � Ip�O � �� � � l. �� W�S�' Q � � �1N �5��
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing Re-Siding ❑Lower Level Finish ❑ Fireplace �
❑Addition ❑Alteration ❑Utility Connection �� 1a� � (�}i ��'J��S (�l� �� �
1 T� .Q��C ��1'�A v� �► �
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc. �
Type of Conshuction: I II III IV V A B pROJECT COST/VALUE $ � � 1 /��
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that [ have fumished information on this application which is tu the best uf my knowlcdge true and correct. I also certify that I am the uwncr ur authonzed agent for the
above-mennoned pr perty and that a truction will conform to all existing state and tocal laws and will proceed in accordance with submitted plans. I am awaze that the buildmg
official can revok t is permit for just ause. Furthermore, I hereby agree that the c�ty official or a designee may enter upon the property to perform nec�ed ms cctions.
X �G 13C�983 � � �
Signature Contractor's License No. D e
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/S"; 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 $ . 1�
This Application Becomes Your Building Permit When Approved Paid ReCei t N
Date Z B
Buildim� Utfiicial Dnte
Th�s rs to certify that the requcst in the above applicahon and accompanying documents is in accordance with the Ciry Ziming Ordinantt and may proceeA as reqocsted. Thls document
when signed by the Ciry Planner consqrotes a temporary CeRificate uf Zoning compliance and aAows construction to commence. Before occopancy, a C�7uficate uf Occupancy must be
issucd.
Planning Director Date Special Conditions, if any
24 hour noticc for all inspections (952) 447-9850, fxx (9S2) 447-4245
4646 Dakota Street Prior Lake, MN 55372