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4-/52-
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
5-.Z-5 -0 L
I. White File I PERMIT NO 2
2. Pink City . C)2- 0271 ~L
3, Yellow Applicant , -W,,"=--
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ZONING (office use)
e /SLJ
LEGAL DESCRIPTION (office use only)
LOT.3 BLOCK i ADDITION t!;1e.e1A-~G H/~LS 21-/0 4CtJ,A/. PID 2-5-28&.' ()03-0
OWNER
(N ame)
(Address)
3' \) ~"^-
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(Phone)C qS .~ \ Li L.{ () - SV'\ 3,
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BUILDER/ LhI /II' C.e-
(Name)~O '" '^'
(Contact Name)
(Address) S/1 JVl&
FreVl.~J
(Phone) l "s' 2. ') .) 24- oS-o'1
(Phone)
tA y,J,.
L Y\ t'- \s\-- {",c.
TYPE OF WORK
ORe-Siding
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 upon the property to perform needed inspe tions.
" ~
"- T
o Misc.
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
o New Construction
~~ower Level Finish
:.3 eI-1S .
ODeck
OPorch
ORe-Roofing
OUtility Connection
"3>- 2; -0-"2-
Date
$
$
$
$
$
$
$
$
$
1- (j 0
25
4211
o Fireplace
OAddition
OAlteration
5-2C;~L
Date
I Paid
Date
~f~ d-~ 0
I ~;ceiPt No.
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
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.
PROJECT COST IV ALUE (excluding land) $
Signature
Contractor's License No.
n Becomes Your Building Permit When Approved
Planning Director
.3 O{)tJ () 0
$ '?47'S-'
$
$
$
$
$
$
$
Park Support Fee
SAC
#
#
-
Water Meter Size 5/8"; 1";
Pressure Reducer
/.~o
Sewer/Water Connection Fee
#
#
"'Y'O . (I 0
Water Tower Fee
Builder's Deposit
Other a..t;;(!;17:.:.-I CV.:f L-
TOTAL DUE
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 4/52. 13etJUGI-JRI'j 8LV.o
NATURE OF WORK L () ~tJ ~ tA5L/E, L--
USE OF BUILDING /c3-F-S" /1//G
"
PERMIT NO. 02-02.(p5 DATE ISSUED 3-25-02-
CONTRACTOR R2eZ.JA/~; J7JH/J / CI-I2UJ77N~ PHONE(952) 324--tJso9
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECT(ONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT +4-0 -- 50<73
INSPECTOR
DATE
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
/j,L(_o]
v
OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
This card must be posted near an electrical s~rvice 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.
:; , 2- (./- (/).
~/ l0-(/\.
SIGNED
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850