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Building Permit 11-1019
/ 00 E0 e ƒ 2 > Ke \ 0 0 0 0 § 0 r k § 2 //\ 2 7 7 g z > c m §d z 73 § a� / r �e �� $ 2 §o g z- / t a- m 2 2 = z q n g / 0 z \ '� z m n § / h 0 > \ 0 f , ,� m 0 2 U . \ z x 0 000000 0 / � ▪ x m mm mrm >m2 ° 2 — 3 °° % x ? - 9 0 » M m 22XX m "' m o 0 ! ® M zIx -z z = ; q > Ooo 0 3 ¥ m , r moo ,3 -71 71 0 k 0 \ k z )c Z § % Z f CO f MI -0 0 m / 0 pa \ j m 1 — m m 000000 — \ z 2 Q-n-nnm � n� »ot 0 mmm ■Q R. • > g P iN q 0 n - - ) m _iz- � � E E u) z ar 0 ii � CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd e. TEMPORARY CERTIFICATE OF ZONING COMPLIANCE x AND UTILITY CONNECTION PERMIT ~4NESO I. White File 2 Pink Cu PERMIT NO. c ., I © 'i 3 Yellow Applicant (Please type or print and sign at bottom) 7 L /ADDRESS ZONING (office use) `� 0 is ..,..e....,- LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID )‘/ OWNER ( il 1 /4_4-, t O.0.7 a l 1/ C' 2.,„ / 9.�� (Name) 16/30 Phone ) (Address) • /(* 0'1- i BUILDER (Company Name) (Phone) (Contact Name) (Phone) (Address) TYPE OF WORK ❑ New Construction ❑Deck ❑Porch Site-Roofing DRe-Siding ['Lower Level Finish CI Fireplace ❑Addition ❑Alteration DUtility Conne n CODE: ❑I.R.C. ❑I.B.C. ❑ Misc. 0 Type of Construction: I II III IV V AB PROJECT COST /VALUE $ 7 S� / Occupancy Group: A B E F HI MR S U (excluding land) Division: 1 2 3 4 5 1 hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. 1 also certify that I am the owner or authorized agent for the hove - mentioned property and that all construction will conform to all exi Ling state and local laws and will proceed in accordance with submitted plans. I am aware that the building o fficial can revok thi p e rm it,f) )ust cause Furthermore, I hereby agree t t the city official or a designee may enter upon the property to perform needed Inspections. Signature Contractor's License No. Date Permit Valuation 2-0-010, ...— Park Support Fee # $ Permit Fee $ 1 4--7.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 $ i k 7 This : icati n o s our Building Permit When A / / rov d Paid 1 .� Receipt No. (�T Z f 1 -- I Date 1'� / t By Mid-- � , r .uil '4!V Da This Is to certify that the request in the abov , .plication 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