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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
~Rr11VI
(Address)'~ 7 - )
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(._~ ; / t '_c }-,~-
1/- ,/-{)y
]. White File I PERMIT NO
2 Pink City . 02 -/ A. (). t::;"
] Yellow Applicant ~ II ..."
ZONING (office use)
PIIbI.9-
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Cj f) -I.JLI 7 - "3 ") 4 ;!
.....e) 1 7~}. . "'1'-1<_' LJ) 7 7
(Phone) Lc II - Ed J- 71 cJ- ~,~-~1t.J..
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t. J,'",_ L...:,llc
TYPE OF WORK
o New Construction
ORe-Roofing
ORe-Siding
OLower Level Finish
PROJECT COST IV ALUE (excluding land) $
o Alteration
DUtility Connection
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 u n the property to perform need inspections,
X - "', ' ~(1.
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $ 0,00
This Application Becomes Your Building Permit When Approved
~~
Building Official
/1 j, 2-/07--
,
Date
//-I./-u).
.
s License No.
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 ~ II./.? () 2-- $3zo4(P
Paid
Date
.3"UJ. ~
//-/ - lJ.,).
I~
~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
~ ~ JI~ ~
. Plannin~J- /( l~tedZ- h,.~ ~con~anY
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Tht' Ct'nlt'r of the l,.kt Counlr,,'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT {j~ /J'7/clU1Lf (p~
APPLICATION RECEIVED / 1- '1- 0 J-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/!)/}&./~ {Z/J/J1dy UZ//C a... /
Accepted With Corrections /'
Accepted
Denied
Reviewed By: ~ ~I'--' Date: 10z.-./d2--
Comments: ~4 ~ ~ - ~ ·
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
White - Building
Canary - Engineering
Pink - Planning
The Cpntt'r of .he Lakt Count'")
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
! I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/
Accepted
~
Accepted With Corrections
Denied
..
Reviewed By:
~ :f~~
Date:
/1112-/az-
, .
Comments:
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
PRIOR LAKE
INSPECTION RECORD
D~PARTM~NT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING
PERMIT NO. ~- ~ DATE ISSUE~~/ II 2/0 ~
CONTRACTOR :::n . A-EI- C'PxJr~0~ONE 6/2 - ?/? - Os-a z--
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
L5:?r..r &bu~ &;0- T/.!.
1JE:1A.J Po I'l-e-H 9 ItJ' X A ' d)cC/~
..
INSPECTOR DATE
I FOOTING W / &<rJ,~Jl~l I ~ I tlLIJ~"!Lt71-
I
~IL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
HEATING (if required)
FIREPLACE r- vi) '()
GAS liNE AIR TEST '] /7A-d5
COVER NO WORK UNTil ABOVE HAS BEEN SIGNED
I I
FINALS
5'-/3 /~J7
HEATING S-,> -VJ
DO NOT OCCUpy UNTil ABOVE HAS BEEN SIGNED
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.
FOR ALL INSPECTIONS (952) 447-9850