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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
White File
Pink City
Yellow Applicant
I PERMIT NO. o~-9/8 I
ZONING (office use)
RI
d-
LOT
LEGAL DESCRIPTION (office use only)
BLOCK I ADDITION
.5''' 3/0- 006
PID
CIIIIii)"
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BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
ORe-Siding
o Misc.
o New Construction
DPorch
eck
ORe-Roofing
DLower Level Finish
o Fireplace
OAddition
o Alteration
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 plavs. I am aware that tl)e building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the ~roperty t
/ ) . '~\ '7 - 7-6 {,iL.--
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Contractor's License No.
. c9("'
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Oili~ $
TOTAL DUE $ J
"f.R
I Paid ?q, Io~ IReceiPtNo,~c. 71
Date 7---a.~V~By ~ .
L
Your Building Permit When Approved
7 -~ ~OC
Date
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
PRIOR LAKE
INSPECTION
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /~2~~S2BqJ
TYPE OF WORK D~IC
USE OF BUILDING 5 r-=
PERMIT NO. 0;;), - y/r DATE ISSUED 7-- ~ (; -0)--
BUILDER ~(/.;ff- .5-tor Jaard PHONE # 'd-33-5;ol::,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING I '.SPEd 171:" / ~:
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I FRAMING I C?..bt- I {{'" t2--~teT-2
I FINAL I ~ I 'lIz-v t'-C::fL
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
C1(~ YZ-Lfz.