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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCF.
AND UTILITY CONNECTION PERMIT
83/85/2888 14:58
9524477437
10 f11-t.,
J,EGAL DESCRIPTION (office use only)
LOT
'BLOCK
ADDITION
O'\VNE
(Kame)
\ (AddreS~~
lV\t_~
BUILDER ~~
(Company Name) &~~Inc.
15789 ISlaM I'M
(Contact Name) _-----1?J:jor1.me MH 55:372
(Address)
ADVAr1CED ItJATER
PAGE 82
Date Rec'd
I WhIrl'
: P'i!'ll
1. VcllC\\v
Pil~
(ilV
A,,~!i(;~nt
I
5/0/0$
LPER1\UT ~O. (Jf'- 00 <7.5 \
ZONlNG (office uqe)
(Phone)
I
J
52:LfJiV-6 g L
PID
(Phone) 9E22-~
(Phone)
ORe.Siding o LO'\l.'cr Level Finish 0 Fireplace
TYPE OF WORK 0 New Con$trUction ODed: OPorch ORe-Roafin>:
DA.ddition DAItl:ration 01..Trility Con.!lcction
CODE:~R.C. OX.B.C. jll--h~c:
Trpc of~~~mlction: I n m IV V A B
Occupancy Group: A B E A HIM R S U
Divi~ion: V 2 3 11 5
I TlliG 1< In omiFy thllthc r~Q\lm;1I the IlbClVC apphc~tlo" .'lId ~cc<1mpanYin!1 ~'XI)mfntq 1< in accoT.j~ncc wHh the Clly Zoning Ordin.\nce 1nd lUIIY pr<Ioeed :\.< rcquc!lcd Thj~ d"cumenl
I ....hcn 91gncd by the C,,,,. PI~lIncr conpttnlte~ ., r.mpC\l'.uy Ccmfie_te "f 7.nning comp!lanee ~nd ~ 11,'",-. ccn<tT\JClIOn to fomm.!ncc Bcfor'. OCO\ltl.ncy, ., Ccrtificate of Occup.\ncy mu'll be
I ""~
Permit 'Pee::
Plan Check Fee
Scate Surcharge
'Penalty
Plumbing Permit Fee
Mechanical Permit fcc
Sewer & Water Permit Fee
Gas FlJcpJace Permit Fee
,2-5"
-...i
,;
$
$
S
S
~
! Thi~ Application BccomeJ Your Building Pennit Whl'n Apl'roved I
I~om,r-~f- ~~~ I
Pl~11nln!t~
._ I),\tc
24 hnll' nntife for nil inqpcctlnn9 (952) 44~.9R50. fu (9~2) 4t.,~tH~
4(,016 O~kolA Street ~. F... Prinr LJlke. ~lnncsotR 55372
~re.lal '(ol\dtt1on~. If .n)'
~{,l'd UJwi~-L
PRO.TECT COST IV ALUE S '-f I eg-O .. ~)
(excluding 13J1d)
Park SUPPO\f 'Pcc
, SAC
W;llcr Meter Size 5/8": 1 ";
Pre~~ure Reducer
Sewer/\Vacer Connection Fee
Water Tower Fee
BUilder's Deposit
Other
#
#
$
$
S
$
TOTAL DL"E
b,oO
'#
#
I paid--li~~n.cJO
; Date "'3 4 ( 02
\ ~~CCiP~>>/(J
PRI)R LAK.. ~~rtD~~~~~TD~~SPECTION
INSPECTION
RECORD
SITE ADDRESS I f..D L( -z.. ~ iTh~;;-c~ A"--E.
. ,
TYPE OF WORK ~ew EGU'SS' Wlt-JQ4IW ~ w.nL
USE OF BUILDING ~ ~J)~
PERMIT NO.. Of;. OO~3 DATE ~SSUED ~/JO l~'
BUILDER ~^NCEL ,/AJI:fIiJLPfJbAps, PH00lE # '~"4/'1)"'~
NOTE: THIS IS NOT A PEtiMIT FOR ANY OF THE IN: PEGTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
_ I ,",OECTO. 1 DATE
PLACE NO CONCRETE UNTIL ABOVE HAS r-:EN SIGNED
I FRAMING Iff". L t.{- .yt!t
I FINAL 1lAf'1 ..: 5+ 0'6
FOR ALL INSPECTIONS (952) 447,9850
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