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CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
( PR \
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE , /L
u tri AND UTILITY CONNECTION PERMIT
47/1
I. white File
2. Pink City PERMIT NO. CZ 3 00
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZQNING (office use)
1746 Belmont Ave NW
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) Kyle Anderson (Phone) 952 - 250 -3812
(Address)1746 Belmont Ave NW Prior Lake, MN 55372
BUILDER
(Company Name)_Bauer Design & Construction LLC. (Phone 612- 860 -5645
(Contact Name) Nicholas Bauer (Phone)
(Address) 17935 Texas Ave Prior Lake, MN 55372
TYPE OF WORK ❑ New Construction X ❑Deck ['Porch DRe-Roofing DRe-Siding ['Lower Level Finish ❑ Fireplace
['Addition ['Alteration ['Utility Connection
CODE: itaRC. ❑I.B.C. ❑ Misc:
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $_2200.00
Division: ,.....--7 1 2 3 4 5 (excluding land)
1 hereby certify t.. hav : urnishe. nformation 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 menti. ed prop ' and t :t 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 c. • revoke t- Ss .ermit f• just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
/ Signature ) Contractor's License No. Date V / y
tt`
Permit . luation 3
i Park Support Fee # $
Permit Fee $ t6e . Z%, SAC # $
Plan Check Fee $ 5-7. ,3& Water Meter Size 5/8 "; 1 "; $
State Surcharge $ l 57C2 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 awn , ¢ ` LS + , $ ( 41 , 1 I
This i.plication ;- , , BuildingPermitWhe Appro ed Paid /1 7 7/ Rece No. 67 5Z. 5
A ii'ill (Z Date 1, Z' /7i BY
Building Official — 0 ate
This is to c• . ify t at the r quest in the above 4pplication and accompanying documents i in accordance with the City Zoning Ordinance and may proceed as requested. This document
when si: by e CI ' anner constitutes a temporary Certificate of Zoning omplian and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
MIL Z I(Z
Planning Director ate Special Conditions, if any
...mmik 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RE ORD
SITE ADDRESS E
TYPE OF WORK ."i..
USE OF BUILDI G
PERMIT NO. D / SUED _A", 20.amp
BUILDER PHONE # 844.5
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
FOOTING I 7/.�
, ‘1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
IMMO
I 1 I
FINAL Corrac ` cr" 1 {� 2 J /' 7
FOR ALL INSPECTIONS (952) 447 -9850