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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
}- 3/-6 Z-
~. ~i:i~e ~:;y I PERMIT NO. /)7 _ O/f) c::- I
3 Yellow Applicant . V~ ~
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT2-ZBLOCK"2 ADDITION (?yct; /,111/ /7 ;7i-:'K'-. V1/{~~ I
PID . - . - ~ -., (, 2 - '.
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OWNER
(Name)
~e ;e.12~ /
(Phone)
(Address)
(Name)~~~ 10!/1 Ro bi~~o f'\- (Phone)h'- Q'5' Z -$? ~t,.-lI ~7lf
(Contact Name) ~~ f' (Phone) JaU (W J9'5 ~ - f2Cj- J- 'If? t..f
(Address)".3-=3q ~ G(m Urc1t- NN ~r\crv ~ MN 5~312---l~(y.J7fJ?(Z~ 53tf- g(pt,-.S
TYPE OF WORK
o Misc.
o New Construction
}(Lower Level Finish
3 ,t:;/r;' <
ODeck
DPorch
ORe-Roofing
ORe-Siding
o Fireplace
DAddition
OAlteration
OUtility Connection
PROJECT COST IV ALUE (excluding land) $
I hereby certifY that I have furnished information on this application which is to the best of my knowledge true and correct. I also certifY that I am the owner or
authorized agent for the above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter on e property t e m needed il1Spections.
X
Contractor's License No.
Permit Valuation ~-:; 000' flu Park Support Fee # $
Permit Fee $ 7<1 "7C SAC # $
. f.~
Plan Check Fee $ ......~- Water Meter Size 5/8"; I"; $
State Surcharge $ I. .5"0 Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ 40.00 Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other EL{;;:c, ?E,2A1 1.,- $
Gas Fireplace Permit Fee $ TOTAL DUE $
1- Jl~Q~
Date
l Paid
Date
;~1.~;J--
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director
Date Special Conditions. if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
PRIO R LA KE DE~ARTMENT OF
- BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 3313 SP/C-./tJ'y GL-6fJ C4teA
NATURE OF WORK LowE-e LEY60
USE OF BUILDING Ph-J /1'/tz-
PERMIT NO. OZ/OIOS- 6ATEISSUED 1-7/~oL-
CONTRACTOR taJf5IA!SOh/ PHONE ?7-.-(q -491
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BEL W
THE PERMIT IS BY SEPARATE DOCUMENT
=--- I :
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
~~
FRAMING
INSULATION
ELECTRICAL
PLUMBING
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
q -/1 -CI)
-( -c:I.)
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SIGNED
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850