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W\L\)S
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
'730.6 7
White File I PERMIT NO
Pink City . 0 7. 0 L q /
Yellow Applicant , (C)
~A12kLAA I.(
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name) Tf1~G T4r-1'~6
(Address)! 4(P "3 L ~t::::.S
PID zs-. z.-71. /) z" 7. 0
(Phone)
c'tl ~ q ~ r - ~Lt,??
PAU:
BUILDER .,---
(Company Name)~!)(L6-S
(Contact Name) Dual)""'"
(Address) IlleS-- Cifl-PI..-€- L-fkG- Ltv-<;
Lv&JCY-L
~eS
~IZ- Z2-c-2.2-1 S-
(Phone)
(Phone)
s- (rG l(
oD
TYPE OF WORK 0 NeW Construction ODeck o Porch o Re.Roofing
DAddition OAlteration OUtiIity Connection
1D
OLower Level Fini~h 0 Fireplace
( 0",:
WIIJ/Ji)~S f Dc-c-/<. ~Ul\/&
PROJECT COST /V ALUE $ 5 eJOtSJ r .-
(excluding land)
CODE: OLR.C. OLB.C. o Misc.
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5
ed mf at ion on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
that a onstruction will conform to all existing state and local laws and will procee . . with submitted plans. I am aware that the building
it ~ JU cause Furthermore, I hereby agree that the Clly official or a des' y enter upon the property erform needed mspectiOns.
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
SAC
#
#
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Building OIlicial
Date
o 7-~o -07
Date
$
$
$
$
$
$
$
$
$
ThIS IS to certify that the request in the above applicatIOn and accompanying documents is in accordance with the City Zoning Ordinance an ,y proceed as requested. This document
when signed by the City Planner constrtutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
isslIed
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS J 4~32 WJ~ --Pku...y
NATURE OF WORK 1..J.'",'oIOlo.1!::. I S,'c(,'lJ' ~~ Uj.'vt&r.Ci) , f..l'.
USE OF BUILDING ~Er I ,
PERMIT NO. 7...fL" DATE ISSUED (0 1~7
CONTRACTOR 7....J-r.e5- - C...sk ~..,.\ Pt!iE C,t12,. 2.2.1 .7:7 t?
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING I
I FOUNDATION (Prior to Backfill) . I ,
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
~~iJ
~
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required) ,t
FIREPLACE
GAS LINE AIR TEST i~ ,~k., 'FV
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
FINALS
LJ.
GRADING (Prior to Sodding)
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, card shall be placed near main entrance.
',,-
FOR ALL INSPECTIONS (952) 447-9850
~