HomeMy WebLinkAboutBuilding Permit #12-0972 � o❑ c� oo0000 � o a N�
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o � PRlp CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE � z � ; r �
.. � AND UTILITY CONNECTION PERMIT
v �,
'�+t�y 1. Whi�e File PERMIT NO ` �
?. Pink City 7 �
; Yellow Applicant �•�'
Pleasc or rint and si at bottom e T —
ADDRESS ZONING (offsce use>
1 �� qb��y � 4 ��
LEGAL DESCRIPTION (of�'ice use only)
LOT BLOCK ADDITION PID
OWNER -, /
(Name) �� ��� �� �� �1 (Phone)
(Address)
BiJII,DER /�
(Company Name) G� u s � �% v S +� (Phone) ,l�3 ^��z'
(Contact Name) ` (Phone) �/'Z ^ ��� 'Z/Z�
(Address) � �� -� „
TYPE OF WORK � New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑URlity Connection
CODE: ❑I.R.C. ❑I.B.C. Misc.
/-�iC7 OfI�'��C�G ���! �Z--
Type of Constiuction: I II III IV V A B ��
PRO,�T GOST�YALUE $ �000
Occupancy Group: A B E F H I M R S U (excluding land) t
Division: 1 Z 3 4 5
I hereby certify tt�at i have fi�mished information on this application which is to the best of my knowlcdge true and mrrect. [ also certify thaz f am the owner or author�zed agcnt for thc
abave-men ed prope�Ty and that ail cunstruct will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the buiidmg
uffici an reve e this it for just cause ore, I hereby agree that the dty officia! or a designee may enter upon the propeity to pe�form nerded mspections.
4 X �., �5�� � � � y �z
Signature Contractor's Luense No. Date
Permit Valuation ���,'� ,� Park Support Fee # $
Permit Fee $ ', SAC # $
Plan Check Fee $ - ��j '� Water Meter Size 5/8"; I°; $
State Surcharge $ r Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Ptumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DtTE $ ���
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This Appiicati c mes Your Building Permit When Approved Paid ReCei t No.
Date B
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im� Utficial Dnte
This ic to certify that the requcst in the abuve applicanon and accumpanyin� documents is in accordance with the Ciry Zcming Ordinance and may proceed as requcs[ed. This document
when signed by the City Planner conshtutes a temporary Certificate uf Zoning compliance and alluws constniction ro cummence. BeFure ixeupancy, a Ceit�ficate ��f Occupancy must be
issurd
Planning Director Date Specia! Conditions, if any
24 hoar noticc for ali inspectioas (9S2y 447-9A50, fax (952) 447-424i
4646 Dakota Street Prior Lake, MN 55372