HomeMy WebLinkAboutBuilding Permit #12-0813 � ❑❑� n O ❑OD❑ � O D ZA
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oF PR/ CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
,, � TEMPOI2ARY CERTIFICATE OF ZONING COMPLIANCE
� x AND UTILITY CONNECTION PERMIT
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M��'NES�SP I. White File
Z P�� �,� PERMIT NO. !� _�� �
l Ydlow Appliunt
P ase e or ' t and si at bottom
DRESS /' � C � � / n J � n � �! � ZONING (otfice use)
Z 7 C� . �/` �
LEGAL DESCItIPTION (office use only)
LOT BLOCK ADDITION PID
owivER / Q j o � C o� Z� �''� l U� �! 4� 1• G� 5� 8
(Name) (Phone)
(Address) 4� l S a �� n({ 5 �� C//. ��
g�,D� THD At- Honie Service, Inc, (phone) � S�l �� • G 0 Y'7
(Company Name)_ 2690 Cumberland Pkwy, Ste 300
(Contact Name) _ Atlanta, GA. 30339-3913 (Phone) _ J d��
(Address) Lic # 20268257 Ph. 763/542-8826
TYPE OF WC�RK ❑ New Construction �[]Dtck ❑Porch ❑RaRoofing ❑Ro-Siding �Lower Level Finish ❑ Fireplaa
❑Addition �Alteradon ❑Utility C:onnection `B,Misc. 3�„�! /) �0 W �� o c� M• n�
CODE: ❑..It.C. ❑I.B.C. PROJECTCOST/VALUE S ,� � g .�
Type nf Consriuction: I II ffi IV V A B (exctuding Iand)
Occupancy Group: A B E F H I M R S U �
Division: 1 Z 3 4 3
I hexeby certify tha[ 1 have fumished infornutior. on this application which is to the best of my imowledge we and co�rect. I also cettify that I am thc uwncr �x authoiizcd agcnt for the
above-mennoned property and that r. ction w�fi confomi to aU exisdng sta[e and loca! laws and will proceed in accordancc with s�bmitmd plans. i am awarc that thc buildmg
official can revoke thu prrmi: for jus a s. Fu*t#Mrmore I hereby agrce that the ciry official m a designee may enter upon the property to peiform needed •caefns
� _ o� 02 � � �� � 7 �� ,�! �
Sig,nature � Contractor's License No. Date �_
Permit Vaination Park Support Fee # S �
Permit Fee S ~ SAC # S
Plan Check Fee S Water Meter Size 5/8"; I"; S
State Surcharge S � Pressure Reducer S
Penalty 5 Sewer/Water Connection Fee #i S
Plumbing Permit Fee $ Water Tower Fee # S
Mechanical Permit Fee S Builder's Deposit S
Sewer & Water Permit Fee S Other S
Gas Fireplace Permit Fee S TOTAL DUE S°�9_
This Application Becomes Ymu Bnilding Pern�it When Approved Paid ReCei t O.
Date � B '
Buiidin OtFcial Date
Thn �s to certify rhat chc request in cfie above application and accompanying documenu is in accordance with [he City Zoning Ordinance and may proceed as requ�stcd. This d�xumen
whrn signed by the Ciry Planner consututcs a temporary Certificate of Zoning compiiance and allows construction to commence. Befixe occupancy, a Ccrtificate of Occupancy must be
issued
Planning D'uectat Date Special Conditions. if aay
24 hour notice for ali inspections (952) 447-98.50, tax (9S2) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372