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OF QRJ3 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
0 N > TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
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AND UTILITY CONNECTION PERMIT / " Z-
4/NNEso'''' 1. White File PERMIT NO
3 Pink City fL' / to
3 Yellow City am / I
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/*XS i, /mss /,74e
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) C /- , .� ... �i e ��je./' (Phone) 7'? 98-03 /..3"--- (Address) / ! y Gc/ ,` /=,_s-' s-, G „,, y
BUILDER o,
(Company Name) %./ /
(Phone) ,-5 --J y
(Contact Name) �s2- /4rc.., . ' (Phone)
(Address) < AP
TYPE OF WORK 0 New Construction giDCtk ❑Porch DRe- Roofing DRe- Siding ❑Lower Level Finish 0 Fireplace
❑Addition ❑Alteration ❑Utility Connection
... CODE: 0LR.C. DI.B.C. 0 Misc.
Type of Construction: I II III IV V A B PROJECT COST /VALUE $ 3 :
Occupancy Group: A B E F HI MR S U (excluding land) I
Division: 1 2 3 4 5
4 1 hereby certify that I have famished information on this application which is to the best of my knowledge true and correct. I also certify that 1 am the owner or authorized agent for the
above - mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can revoke this permit for Just cause- Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
I x 1 -. .0.5 /(J' - /;
Signature Contractor's License No. Date
Permit Valuation *00- — Park Support Fee # $
Permit Fee $ 9,I_ Z ,", SAC # $
Plan Check Fee $ Z(o . Si Water Meter Size 5/8 "; 1 "; $
State Surcharge $ _ So 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 0, i Li (1 z. $ (8 . S',
All
This Application Beco es ' t ur Building Permit Wit: A + , oved Paid 'receipt No. "10
Date /1. Z., ( 2, r %y
r' 10 (- i .
Building tticia Date
This is to certify t t 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 -/ Cit 'limner constitutes a temporary Certificate of Zoning m fiance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued. /
AL As L
H Planning • 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
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ADDRESS: 1 444 ck LA- '-ua PAp.,_,,,t,,,/,.i PID:
PERMIT TYPE: ql(� 111 DATE INSPECTED: / ' / 1 6"7
ADDITIONS /BASEMENT FINISHES /PORCHES
FLOOR COVERINGS: Exterior Siding
Interior Wall covering
CEILING COVERINGS: HEATING:
BATHROOMS: FULL: 3/4: 1/2: OTHER PLUMBING FIXTURES:
BEDROOMS (addition or 6smt only) # CABINETRY:
FIREPLACES: 3 Type
% OF TOTAL BASEMENT AREA FINISHED: Bsmt Fair Bsmt Avg Bsmt Exclt
OUTBUILDINGS
BUILDING STYLE: FLOOR:
WAILS: ROOF:
HEATED: INSULATED:
FINISHED AREA:
OTHER /NOTES
PRIOR LAKE BUILDING A D�NSPECTION
INSPECTION
RECORD Pk4W,V
SITE ADDRESS � Wi'.Oi
TYPE OF WORK tt
USE OF BUILDING
PERMIT NO. I DATE ISSUED /0. ?fa 12.
BUILDER PHONE # S
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIO S BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
FOOTING 1 Gds L << 2r l rz
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I FRAMING I I I
I FINAL I /✓ L � /z/sip-
FOR ALL INSPECTIONS (952) 447 -9850