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Building Permit 11-1026
0 0 n 0\0000 -2 o a >g _ 0 e ° ° ° ^ 0 § z Kk k§ 0 m k § 2 2 7 - z z $ -� % § ` Z q §° o g 2- / t wirn ) _ m 2 z § o S. \ �y \ z m m / 0 r_ z ° to m R 3 ; _ \ j § 0 0 000000 q m m m m i> m r 2 ® - ° ° x mx - 0 0 » o m ) § K ® m 2777_7 q 2 ? M § q >000 0 M H m _ m = • 0 q 0 0 2 ■ r - n oo 70 - , > cc Z / / % 0 f CO ��� 0 m 2 I ) • c 0 / 0 00000 | ° , z z c1mm 0 O �/ / < ° � / 0 k o >mm q - _ k 71 w q7 0 o f PRIp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd ,� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE e AND UTILITY CONNECTION PERMIT U � 41.4,NEsole' I. While File 2 Pink city PERMIT NO. ( -to 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) /5 /7b E�- E,✓ C,/L LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER ) b� 1 ? k / ,_ \t J (Name) 1 J � . (Phone) (Address) / 57 (G' Et. t !J C ( BUILDER Name) Oil -- £- - C`,' , (Phone) �Z 2 3,),.)i) (Contact Name) U ,7?,J ell'-A (Phone) 6i Z �i 7 '/ f�l'O (Address) L/3 "L. S 5 u A›.J L. ekKe � 1 i„ . TYPE OF WORK El New Construction ['Deck ❑Porch Roofing ❑Re- Siding ❑Lower Level Finish 1=1 Fireplace ❑Addition ['Alteration ['Utility Conne tion CODE: hI.R.C. ❑I.B.C. ❑ Misc. Type of Construction: I II HI IV V AB PROJECT COST /VALUE $ Occupancy Group: A B E F HI MR S U (excluding land) Division: 1 2 3 4 5 hereby certity-ttlat l ave himished information on this application which is to the best of my knowledge true and correct. I also certify that 1 am the owner o authorized agent for the above -me5k ned pro eny and at all c¢ struction I conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official c revoke this per r just . e Fu ore..I hereby.agree Ghat the my gfftcial or a designee may enter upon the property to perform needed insp cnons. X Zd631Z /G // Signatur Contractor's License No. ate Permit V aluation �_ Park Support Fee # $ Permit Fee $ . s -- SAC # $ Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $ State Surcharge $ S _ .- Pressure Reducer $ Penalty $ Sewer /Water Connection Fee # $ Plumbing Permit Fee $ Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer & Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL DUE $ /q, 7 This • . ' • * Becomes YourBuilding Permit Whe Ap oved Paid 11- 75 Receipt No. f ZIT Date / ©�-¢�� By j '.: ilding .- Date 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 all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street Prior Lake, MN 55372