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e 1 0 �� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
ti TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 8 _ 3 0 ' 2,
c,.' tr' AND UTILITY CONNECTION PERMIT
AtES
L White File
z. Pink city PERMIT NO /z. /007
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS t r_{ 3 fo O p ,t„ Q ,_S t D C o .-)1-1— ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT 1 S BLOCK t ADDITION 6 1 - S V V P - R-U r PID
OWNER
(Name) '1P. M `ti -14 O M ES (Phone)
(Address) '12 I W A S H. I -1 6 t. v 2 s ST 20 ► a.O t tJt . M N S S 4 3
BUILDER
(Company Name) 1-11 4-1-0 t"t ES (Phone)
(Contact Name) S v E- 8 (Phone)
(Address) 12-C) t l"., Pr S H tt-1 (TO'! 1 S ST 7 r, t 1=0 t N t, M 1 SSA 3)
TYPE OF WORK jg New Construction LIDeck ['Porch ❑Re- Roofing ❑Re- Siding ewer Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc:
Type of Construction: I II III IV V A B l 0 v O 6
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I 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.
x_.-'-'s----1:: _ — 2 -3 S2 ,b ° v - 29 - ( 2
Signature Contractor's License No. Date
Permit Valuation Z/ OC E' C C Park Support Fee # $
Permit Fee $ L z Z s SAC # $ •
Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $
State Surcharge $ / Z i ` Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ .74-- SZ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ /1 7 75
This Application Becomes Your Building Permit When Approved Paid //7 "' - 7C ceipt No. 6
Date 7 6 f- - /Z:
Building 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 S.E., Prior Lake, Minnesota 55372
AUG-29-2012 08 : 49 C I TY OF PRIOR LAKE MA I NT P . 02/0 nA g
sVitto Date Reed
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A,; • .7g,-.c, CITY OF PRIOR: 'Ala PLU.MKNO PERMIT
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24 hour n*tica #tr stEiospeel �+ n441914�9, Om (952) 441.4 4S
44�It� 110,Ma Sind IL , Mtn' Lake, XI/li tstel* 5531Z
PRIOR LAKE BUILDING AND INSPECTION
„-
INSPECTION RECORD
SITE ADDRESS /4%t PR L flE er:
NATURE OF WORK
USE OF BUILDING k . . AI .
PERMIT NO. D 'TE ISSUED
CONTRACTOR FilnritAte PHON
NOTE: THIS IS NOT AT FOrt ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
!NM
1 `
1 1 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1 1 1
FINALS
BUILDING
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