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O "44 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE j f f5 i Z
.. x
x AND UTILITY CONNECTION PERMIT
U
y'ANESOi� I White File PERMIT NO. �f
D Z . / 2 Pink City /2., 2
3 Yellow Applicant // /
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
I 26 )oco Duu. R r_ I
LEGAL DESCRIPTION (office use only)
LOT44LOCK 3 ADDITION PV' O5 56 C/n PID 2.5 382... (la.
OWNER
(Name) 1) t 9- L NUEE. I g v1-1 Pl. (Phone) '
(Address)
BUILDER 41.- //��r1 ii
(Company Name) 0 01 O6& C Sr \ C1 D 14. 13 U 1 L V (Phone) C S I 2 � -' I I
(Contact Name) {r, SC (w Re t N MC FLK (Phone)
le 2C lc Lie K J i LL t.' 'T r, L IN Wi ILLL. ' $) sls6 Li L\
TYPE OF WORK ❑ New Construction ['Deck Porch ['Re-Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace
['Addition []Alteration ❑U ility Connection
CODE: [3I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II 111 IV V AB PROJECT COST /VALUE $
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that 1 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 /11 ►o– 4q— gc► 2– C 1 L 1 - 1 €5- I/
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
rZ- 0 00 .
Permit Fee $ .� t SAC # $
Plan Check Fee $ t 4 3 . Ga G. Water Meter Size 5/8 "; 1 "; $
State Surcharge $ (o - — Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $ r'
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE 611.1a> 4. j q: r $ 3 70 /' . 6. 5
This Appl' ion :e • es uilding.Permit When Approv Paid 3�` 0. � f R ipt No. 4 vim-/'
!i Date ( ., ? . 1t — B
�� 4 I ll I. 'f l it. q._
•uildinu Official `ate
ti
This is to certify at the request e abo ° pplicat to 9 accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed e City lanne. ct sti , 01 tem.or ry Certificate of Zoning com liance d allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued 11 , 14
I lanning Direct Dat I Special Conditions, if any
! stice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS /53Z00 VJOO.D DO L1‹.
TYPE OF WORK f
USE OF BUILDING /2�
PERMIT NO. /Z. ZVCn DATE ISSUED 4 - . /% - /Z
BUILDER 007 001a c5P74 Gam.,; PHONE # 5I z
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING 1 g‘c,
PLACE NO CONCRETE UNTIL A OVE HAS BEEN SIGNED
I FRAMING Q/6// 1
EGC GT2r cAt c- 1 ' f
I FINAL 1 R4 -I ��
ems. � L r
FOR ALL INSPECTIONS (952) 447 -9850