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OF PRIp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 2 G 1/
AND UTILITY CONNECTION PERMIT
a,� , NE S �q!' I. white File PERMIT NO . 7k3 3 Pink Cp /
3 Yellow A
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
3 21 B trlit-v t C-i C -- PP I'D i - 1-44 r MCI 5S3 72
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER ` 11 y tiY yy�
(Name) J∎ OA O I MAY &t �s C U H ( Ph one) R 5 2- -
(Address) 24 yi C ((4 _ 4) ,( Lae MN 5137 ,
BUILDER
(Company Name) .--)De- f Iqh D49 Cres1Yu(,'ol £ . ` -� - 11 C (Phone) 'K2 - 9410 - 53s 'y
(Contact Name) JDG- HA 1) D 1w�/ (Phone) 9I 2 — 25o -3330
(Address) 9 10 2 17'4 5+ /l .4 ic4r 1.4 Mfj 53 72
TYPE OF WORK ❑ New Construct ['Deck ❑Porch ❑Re- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace
DAddition MAlteration ❑Utility Connection
CODE: DI.R.C. DI.B.C. ❑ Misc.
Type of Construction: I II III IV V AB 36 a D
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $ -x[71 �a
(excluding land)
Division: 1 2 3 4 5 i
I 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 , uthonzed agent for the
above - mentioned property d that a construction will conform to all existing state and local laws and will proceed in accords . motto plans. i am aware that the building
official can rev .ke this per/it for jus / ause. Furthermo : ee -that the city official or a designee may enter upon the property to perform needed inspections. L.
X tf 1� I � ii—. r
_ ._ 2 3y b 9 /9 Il
Si a.. - Contractor's License No. ' Dat
Valuation 5-6 0 ` 0 0 Park Support Fee # $
Permit Fee $ a5 G 0 SAC # $
Plan Check Fee $ /6- 2s- Water Meter Size 5/8 "; 1 "; $
State Surcharge $ t 57 Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ 5 4 5-0 Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ 7& / _ 2
This Applicati t 1 • comes Your Building Permit When Approved Paid etc, 2 f � Rec t No. ��. se
Date 2 d , /1 By
-
;Lidding Official 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
DEPARTMENT OF
P R
R LAKE DEPARTMENT
AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS 3Z/ S et// / EAU T ei /2-
NATURE OF WORK
USE OF BUILDING /CVs' ft //L
PERMIT NO. /t , x! DATE ISSUED 9. Zo. <
CONTRACTOR OD E 4- 14 otJc PHONE 4
I
NOTE: THIS IS NOT A PERMIT FO OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
011111111
1 1
1 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING - . 6 OA ��1
INSULATION
ELECTRICAL
PLUMBING
IMMO
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1 1 1
FINALS
BUILDING 1
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