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OF PRIp�
0 CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
F ;
TEMPORARY 1D CERTIFICATE OF ZONING COMPLIANCE - ,
Smoke Ciettc �1 g N P ERMIT
as per the requirements of the IRC
~ ' " ° `� throughout the house Battery operat e File pERMIT NO. /� ��
T� "
� . pink city `
(Please type or print and sign at bottom) smoke detectors may be installed j eunw Applicant
ADDRESS e. existin structures ZONING (office use)
p —T-
LEGAL DESCRIPTION (office use only)
Smoke detectors shall be located PID
LOT BLOCK ADDITION in all sleeping rooms, on each story.
OWNER N � ` �` ILL__ and, in halls to sleepin roo
(Name) (Phone) ) � �� ?:44 (e, l 1.4, 1.4, tcl. - e__ f
(Address) 3 c d t.t,.7;.t ) L-�, T"i. s T i_
1 BUII DER ^^ � C O I a Q --Z 1 o�
(Company Name) �t�.�,� � C�n - I - et-C. (Pho _
(Contact Name) . r. +z (Phone) RS a� 41iC7" S 1 45 ta
(Address) 3 .vs. � 7 Gt- 02 k 'ILL S GJ 4L
TYPE OF WORK ❑ New Construction DDeck ❑Porch DRe-Roofing ❑Re- Siding DLower Level Finish ❑ Fireplace 44,11 *---",
['Addition DAlteration ['Utility Connection
20 T
CODE: ❑LR.C. DI.B.C. ❑ Misc.
Type of Construction: I II III IV V A B .1'0 Occupancy Group: A B E F H I M R S U PROJECT COST /VALUE $ / Cr)O •
Division: 1 2 3 4 5 (excluding land)
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 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 ca A evoke s ii it f. ust cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
1 Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $ •
Permit Fee $ SAC # '
Plan Check Fee $ Water Meter Size 5/8"; 1 "; $
State Surcharge $ 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 $ 44 r 15
This Ap icatio Be es Your Building Permit When ppr.ved Paid . 2 Receipt No. C:4 9--2_
0 - Date By RP
Building Official – D to
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
s
PRIOR LAKE DEPARTMENT
A D�NSPECTION
INSPECTION
REC R D SITE ADDRESS W!1J-OW8 7Z
TYPE OF WORK W DeS
USE OF BUILDIN
PERMIT NO. ATE ISSUED , q, / L
BUILDER PHONE # &Z. 1400
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
IMO
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I FRAMING
FINAL
FOR ALL INSPECTIONS (952) 447 -9850