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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1- ~~ ~ () l--
~i~i~e ~::y I PERMIT NO. /'l ") - 0-..0 I
Yellow Applicant U oi 7 d-
LEGAL DESCRIPTION (office use only)
LOT r BLOCK ,3ADDITION
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ZONING (office use)
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952. </C/S- - I) 1 S-
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BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
OPorch
OLower Level Finish
~eck
o Fireplace
ORe-Roofing
ORe-Siding
OAddition
o Alteration
OUtility Connection
PROJECT COST IV ALUE (excluding land) $
o Misc.
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 upo~ th~ propeItJ:to perform needed' ections.
X
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $ I.SO
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
ecomes Your Building Permit When Approved
I,?,CQ-Crl
Date
Contractor's License No.
o~
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ /38 _ 9J ("
Paid
Date
!(~- 8t
-7.,6."
I ~~cf- "'tIttJ
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
JAN-26-2000 13:09 LL
JAMES R. HILL. INC.
612 890 6244 P.03/03
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CERTIFICATE OF SURVEY
For:
Metro Classic Homes
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Scale: 1"=30'
Page' 2 of 2
James R, Hilt Inc.
TOTAL P. 03
-.I
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS Jl\.~G8 <6(ue\o~d \,}
TYPE OF WORK Dee L<-
USE OF BUILDING ~Fy)
PERMIT NO. (J 2"092- DATE ISSUED 7,.2~-OL
BUILDER "~~"'-t' r PHONE # 9~2. (fqS. frO-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
FOOTING
PLACE NO CONCRETE UNTIL ABOVE HAS BEE
I FRAMING I I
I FINAL
I 4-, rrjr;loZ/
Call between 8:00 and 9:00 A.M. for all in$pections I
FOR ALL INSPECTIONS (952) 447-9850
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