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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
.3.. 27,tJZ_
IS?,2;
8\
l-\ov n
Pa.~ ~
I. White File I PERMIT NO ~
2 Pink City . OZ- 0
l Yellow Applicant . _
ZONING (office use)
R./
LEGAL DESCRIPTION (office use only)
LOT /0 BLOCK Z ADDITION WIC05 5TH
OWNER
(Name) e.ob +
(Address) I f) ~)Z
<;ha.~h tL Ba. k-t-V-
Ht> Yn.. f)A..~
BUILDER
(Name)
(Contact Name)
~vrh t.-v
~"I
(Address) 14-4 DD ~\..'Vl ~
r .bh<.. --hvu::-h bY)
gtl v.-hira
TYPE OF WORK
o New Construction
OLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
~ f:DO
o Misc.
PID 25~3?5- 6/5-0
(Phone)
q f;z- L2lR - tpSZ.D
(Phone)
(Phone)
'i ~ 2- - 44 D . .., 150
vYl <;. V" , l
Y1tJ
t;~ ~ [) V->
ORe-Siding
OUtility Connection
Deck
o Porch
ORe-Roofing
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 u~on the property~ tperform eeded inspections. ) J
X ~ e .__ 2"b1-llP It 0 3 2(P o--z-.
Signatur Contractor's License No. Date
OAddition
OAlteration
Permit Valuation 3 0 (')l') , OC:>
Permit Fee $ 83 . 2c::-
Plan Check Fee $ 5'I.ll
State Surcharge $ I.SO
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
s Your Building Permit When Approved
5.27-CJ~
Date
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
,paid~/38.2~ Gr.r.
Date -:3(.>-'7)('1 '"Z-
I ~;c~ ~j~~
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
TOTAL DUE
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
'*
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS J53~3 13\9 \4o~ \Ja.~~
TYPE OF WORK Deck
USE OF BUILDING S~D
PERMIT NO. ()Z-02M- DATE ISSUED 3-;)''7-~
BUILDER --.finvd-l<>.t: C"", shu~hQy\ PHONE # 95d..-tft./tJ-775"O
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING 0;2
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I~ I I I
DATE
Call between 8:00 and 9:00 A.M. for all inspe lions
FOR ALL INSPECTIONS (952) 447-9850
FINAL