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IS{ ~
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/. 15. 08
c,. /()70
I White
Pink
Yellow
File
Cjty
Applicant
I PERMIT NO. 08. ()OZ/ I
(Please
ADDRESS
5(P04-
7Aeri/LHe,.qD LANe S6
ZONING (office use)
tel
LEGAL DESCRIPTION (office use only)
LOT /4-BLOCK
ADDITION &NCLA'Ve; /tr ~~y U'9-K.S
I
PID z.s: +54-. a.3~. 01
g,= ~Of}a/d'~1A G/~~
(Address) (g e.d. e.. C
(Phone) tJ!5:J. -t55-Wf/Q I
I
i BUILDER
I (Company Name)
I (Contact Name)
I (Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck o Porch ORe.Roofing ORe.Siding
OAdditlon OAlteration o Utility ConnectIOn
Lower Level FinIsh 0 Fireplace
;;? /L,MS.
CODE: OI.R.C. OI.B.C. o Mise.
Type of Construction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A n E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certlty that I have hlfnJshed mfmmatlOn on this apphcatJOn which IS tD the best of my knowledge true and correct. I also certIfy that I am the owner or authorIzed agent I"l' the
above-mentIOned property and that all ,_'onstructlOn WIll cont(Jrm to all eXlstrng state and local laws and WIll proceed rn accordaoce with submItted plans I am aware that the buIldrng
otfiu,11 can r vo e tlm pelmIt tm Jusrz"le ;llIthelmme I heleby agree that the CIty offiCIal or a desIgnee may enter upon the plOpelty to perform needed II1Spectlo!)s
X / .A:SJ.(JJ~~ /-/~<J?
Signature Contractor's License No Date
Permit Valuation
3{OOO.6u
"14,75
Park Support Fee
SAC
#
#
Permit Fee
$
$
$
$
$
$
I $
$
1_ 50
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
#
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
~echamcal Permit Fee
60.00
Water Tower Fee
Sewer & Water Permit Fee
Builder's Deposit
Other
Gas Fireplace Permit Fee
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
Date
Btllldll1g OfIiclal
ThIS IS to certify th;I1 the request 111 the above applIcatton and accompanYll1g documents IS 111 accordance WIth the City Zoning OrdInance and may proceed as requested ThIS document
when sIgned by the City Planner CllIJstrtutes a temporary Certltlcate of ZonIng complIance and allows constructIOn to commence Before occupancy, a CertIticate of Occupancy must be
isslIed
Planning Director
Special Conditions, if any
Date
2.. hour noticr for all insprrtions (952) ....7-9850. fax (952) 447."245
4646 Dakota Street Prior Lake. MN 55372
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS --5 C-- 04-~/( ,/-( Dq D L/1 /\-IE
NATURE OF WORK LOtl/c- Ie' L..{. t/c. Z-
USE OF BUILDING ;C:c _~- /1 P<--
, /
PERMIT NO. OC:j.OuZ/., DATE ISSUED I. IS.Of;
CONTRACTOR (]/65E /YJ/1N_ PHONE A65. 4-44-S
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PE:RMIT IS BY SEPARATE DOCUMENT
~G I )
~IL ABOVE HAS B~EN SIGNED
ROUGH - INS
INSPECTOR
DATE
:~
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
- l_ J
FINALS
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 serViCI! cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850