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[ll zc:c: Z r Z :-1 m ~"ll"ll 9 m c N "TI 0 ~ .... 0 r :t: ;:0 m ~ 0 0 ........... c: 0 , ~ :xl en < 000000 ....... m ~ Z :xl C>"TI"TIO~ ~ > z >SiiSiiO Ao 0 (i) ~mm:l:(i) ~ ~ _"ll-o"llS! ........ ~ Z ~!;!;!;c 0 >ooz=i'j ""l !11 _mm-l_ ~ ;:O"TI;:O r -I -1-- r i enz z m -I~ C> CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT ADDRESS ? '~lCJz /YJa /' / { LEGAL DESCRIPTION (office use only) LOT BLOCKS-ADDITION OWNER (Name) (?/h 611~r It 11jd rctu (Address) Date Rec' d I. White File 2. Pink City 3. Yellow Applicant xkd PID L (Phone) '1'(/7 -710 ~ BUILDER C -, (Name) ~~~- (Contact Name) (Address) (Phone) (Phone) TYPE OF WORK o New Construction o Porch OAddition o Alteration OUtility Connection .&'J.Lower Level Finish ODeck ~Fireplace ORe-Roofing ORe-Siding 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 upon the property ~ PJf~ded inspections. ~...._'~ __ ~?-/--o/ Signature Contractor's License No. Date Permit Valuation ~ , Od:).OU Permit Fee $ (..2....Z.5 Plan Check Fee $ State Surcharge $ ( .~O Penalty $ Plumbing Permit Fee $ l..lD.C9() Mechanical Permit Fee $ Sewer & Water Permit Fee $ Gas Fireplace Permit Fee $ .,frJ .00 es Your Building Permit When Approved t1-2 -J.c>Ol Date Park Support Fee # $ SAC # $ Water Meter Size 5/8"; I"; $ Pressure Reducer $ Sewer/Water Connection Fee # $ Water Tower Fee # $ Builder's Deposit $ Other $ TOTAL DUE M1u~.D CJ-13~O I $ /~3.25 . \ ~Jttt~5M/ \ Paid Date /43~ tJ"'/ .... I 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 a\l inspections (952) 447-9850, fax (952) 447-4245 White - Building Canary - Engineering Pink - Planning The C('nler of 1he Lab Country NAME OF APPLICANT BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST U?l~~ (!Mf;vJ ~J- 7-0/ APPLICATION RECEIVED The Building, Engineering, and Planning Departments have reviewed the building permit application for construction activity which is proposed at: 11[1/9 C/ oO-~ [jJ Accepted Accepted With Corrections Denied Reviewed By: f2f ~~ Comments: i<lU& +k~~ nk"~ ~J-- Date: 'l-/2-~/ "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." Residential Building Permit Checklist Basement Finish or Interior Alteration to Single Family Homes By:r;}> c Date: l~ ~ '7-:C) ( Building Permit # Site Address Pill: _ Zoning: /1 i//9 e D{1~!l~(0Z--) Legal: L B Subdivision: Existing Structure: YES or NO CONFORlvlS TO ZONING YES NO ORDINAL~CE [ I YES I NO Is this an expansion of the existing footprint or Refer to Plarming ':I- building height? Is the property located within the flood plain? Refer to Planning ~ Does the alteration include any additional kitchens? Refer to Plarming \ y Does the proposed alteration include any outside Refer 1:0 Planning X entrances other- than patio doors? Is the proposed use of the finished space or Refer to Plarming )Z alteration for anything orner- than a normal single family home (office, grou~ home, day care, etc.)? THIS CHEC1G...IST MUST BE COMPLETED .-.\.1'1D INCLljl)ED IN THE BU1LDING PE.&'1llT Fll..E TO MAINTAIN A RECORD OF THE REV1EW. T \"'T'"'T"'" ("T"'lT ....""r'C, ... T ""''''''''TJr''''J''' nnr PRIOR LAKE INSPECTION RECORD DEPARTMENT OF BUILDING AND INSPECTION SITE ADDRESS 4'-111 COC1~ma.V\ L" NATURE OF WORK c-g~ ~..'>.4Kk USE OF BUILDING s. FD PERMIT NO. ~o 6 DATE ISSUED "1- 1'--0 I CONTRACTOR J:J ~DLLw-- PHONE rf'l'7-7r;lIJ ~ NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT ~ I I PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS INSPECTOR DATE FRAMING INSULATION ELECTRICAL PLUMBING HEATING (if required) '" '07 COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED I I FINALS c=--- __ __u_ BUILDING ELECTRICAL PLUMBING HEATING 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, car~ shall ~e placed near main entrance. Call between 8:00 and 9:00 A.M. for all inspections FOR ALL INSPECTIONS (952) 447-9850