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Building Permit 12. 1179
5 0O• 0 00000 0 a sn k J§ . 0 . -n K7�� 5§ k 94 -4 .> o P § / 22 � r E §§ z 2 2� t q q> 2 V -4 Q§ ® P o73 / t -4 M O X g §§ z mk § o » > k 11111111i. / m o z 7 x 00 oOO�QO Li. q mm fi ® r E -I 4/$ 1 C § - 4 C ) S % 3 -0 f § �- � � 7 d z Se m 0 \ 0 UV \ 0 k 2 >0Q0 0 @ § trj 2 § a al . t c � z c % z@ m 2 r -0 -a p m ill 0 M o § k _ � OOOOO 1 o ■ 2 A 7 ¢ 2 2§§ ' A ® comm3® • \ 0 §0c) w II M .4 r I -1i § of PRI% 0 CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE f 7� v AND UTILITY CONNECTION PERMIT ;�A►NBS��� 2 White City PERMIT N O. /z /177 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS .. I Gia r c , I a ZONING (office use) ci LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID (Name) OWNER V Vet ' t 4 :• 1 (P hone) E O '' .. q)1 - J (Address) BUILDER (Company Name) (Phone) (Contact Name) (Phone) (Address) TYPE OF WORK 0 New Construction ', l- ck ❑Porch DRe- Roofing DRe- Siding ❑Lower Level Finish ❑ Fireplace ❑Addition DAltera ion ❑Utility Connection CODE: I.R.C. DI.B.C. 0 Misc. Type of oC� ns�eruction: I II III 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 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 ail existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official can revoke t. is permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed Inspections. ' ■ /0161 12. X iiii Sign re Contractor's License No ate Permit Valuation 1A O ©, — Park Support Fee # $ Permit Fee $ S4 ZS SAC # $ Plan Check Fee $ 3 5 01 b Water Meter Size 5/8 "; 1 "; $ State Surcharge $ „t o 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 L'�hb / p /fi /L $ q0. 2-1 This Appllation : / ∎me Your Building Permit Wh= Ap• Ived Paid q. 2. / Re eipt No. 67}1-21 �� Date /p. / 7,rL haahaglibt.... hd g rz Building Official &ate . ■ This Is to cent' N that the request in • above application and accompanying docu. ents is 'n accordance with the City Zoning Ordinance and may pro 'ed as requested. This document when signed„, the j �P 1 er c. /notes a temporary Certificate of Zoning co piianc and allows construction to commence. Before occupancy, a - plicate of Occupancy must be / issued / I&,... dk ok[ (o 0 l Z Planning aia'sr: gate Special Conditions, if • 4 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646 Dakota Street Prior Lake, MN 55372 . • PRIOR LAKE BUILDING AND ONSPECTION INSPECTION RECORD � � SITE ADDRESS ' � s��a ViEI/ �`"V TYPE OF WORK ��� USE OF BUILDING D � PERMIT NO. 11i DATE ISSUED I0 , S• BUILDER 7 /oti 's PHONE # 50. Aft /25 JwS NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT INSPE DATE I FOOTING 1.06. 1.06. � j /Z y 1 PLACE NO CONCRETE UNTIL ABO E HAS BEEN SIGNED *MK 1 1 FINAL 1 I{ I 3 - FOR ALL INSPECTIONS (952) 447 - 9850