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7- 3/. 06
tu(.JA~AN
I PERMITNO'08~ OSfe...sJ
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White File
2. Pink City
3. Yellow Applicant
RcD DA1<'S RD
Date Rec' d
ZONING (office use)
~~o
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
PID z..s- .04-2. . (J oCo. 0
BLOCK
OWNER
(Name)
[3, e.-+t f
I ~s. ()
cJ~$$i( A /fIiele.t'\
(<::$ t<tJ.
(Phone)
C,12-4'11J-lr~7
(Address)
BUILDER
(CompanyName)f)~c...f< f ~t!JF<. ltJNl/JAt.JY
(Contact Name) J" AN .5'.f? If IN (, E'R-
(Address) 6 00 I Sf sT T Lr;
(Phone) 952 J1;Jz - /888
(Phone) 1S2--1 J2. -18/39 X ItJ3
/2
TYPE OZORK 0 New Construction 'lck OPorch ORe-Roofing
OAddition OAIteratlOn ~DUtility Connection
. 0 KfiIL//V'G
CODE. I.R.C. I.B.C. 7 0 Misc:
Type of Construction: I II ill IV V A B
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
ORe-Siding OLower Level Finish 0 Fireplace
PROJECT COST /V ALUE $ / ~ 7/ 1- 00
(excluding land)
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 10ca1laws and will proceed in accordance with submitted plans. I am aware that the building
official can revoke' it fo . t cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
S-1-57 7/29/()8
Contractor's License No. ' Date
x
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
#
#
Permit Valuation
Permit Fee
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
TOTAL DUE
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
Builder's Deposit
Other
$
$
$
$
$
$
$
$
$
. m.g P,.m~ TjoW;"d
Dat
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
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
Special Conditions, if any
PRIOR LAKE ~~r~~~D~:s"ECTION
INSPECTION
RECORD
SITE ADDRESS /55/0 1Z60 OI7K.S ~.
nPEoFwoR.K .~~ ~f~/lVq
USE OF BUILplNG _ S . /II ~
PERMIT NO. CJ8. oSl::>S- DATE ISSUED 7 3/. 08
.
BUILDER DECIC-- ~ DOOrc c...D. PHONE #
. NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
-, FINAL
L
.--- I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
~ f I
I ftJ; ~~
I
I
f
FOR ALL INSPECTIONS (952) 447-9850