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�F pR� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
�- AND UTILITY CONNECTION PERMIT
Irj
i. White File Pink City PERMIT NO .
2
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��HNESO�� 3 p . ..(� '
Yellow Applicant 1
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
1 CZ (0 Z,3 Lyt ) 4 S aV •
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
', OWNER .
' `J (Name) 1 G o \ e. 1- P - 44 2 (Phone) (0‘ L " l q 5 9 C(.12 t
(Address) 1(Q CO 7 3 L /OAS A\V t_ 1 '''Pi r, r 1.--4 k i2. , M ft)
BUILDER ('
(Company Name) Qt.�•1. ciM R Q. Call S1. LL(..... (Phone) (0 —12-
(Contact Name) ' DQ A A L, el.) (Phone)
(Address) 41 L I Vi a vil , ° i l S I NJ . CS D (Q
TYPE OF WORK ❑ New ConstruS n ��'Deck EPorch ❑Re- Roofing EIRe-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ,�^ ' -_n ❑Utility Connection
CODE: 1 yf .R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II III IV V A B PROJECT COST /VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I I hereby certify that 1 have hirnished information on this application which is to the best of my knowledge true and correct. 1 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 p - • it for st cause Furthermore, 1 hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
LOO" 31S 3 7- Loll
Signature,
Contractor's License No. Date
Permit Valuation --45e Park Support Fee # $
Permit Fee $ 25.- SAC # $
Plan Check Fee $ l f CO .2.$° Water Meter Size 5/8 "; 1 "; $
State Surcharge $ .5o 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 $ 4 1 „ 7 - )
This ' - ,licat',n :: ' es our Building Permit Whe App ved Paid /J 1 7.. Receipt No. -3317 0
I I / Date 7 /7 /ii By 1
. .4.0 / - 11
"Buil v ms 01 icia' ate
This is to cert • at t f re, in the above application and accompanying documen is in ccordance with the City Zoning Ordinance and may proceed as requested. This document
when signe • he / r P f r s totes a temporary Certificate of Zoning comp nee d allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued /
A. ./ um 7 l r
Planning rs'Nirill ate Special Conditions, if any
r notice 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 ' L"i ti�
S I Li
TYPE OF WORK ,_, � Lr 1
USE OF BUILDING A P---
PERMIT NO. (L 69 1 DATE ISSUED - 1 '7 /II
BUILDER u/-_ cri (Lv t :, ,,,.. L L.L. PHONE # 0 Z. ?2-``1 -/7-10
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMEN T
INSPECTOR DATE
I
FOOTING 1 PH )///111 1 I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I:eiiiMIEW 1 I
FINAL I '"°'r r°'Z 1 3 ,),7 I
FOR ALL INSPECTIONS (952) 447 -9850
•
12767 c)7) 1 7 —(U
HARRY S. JOHNSON LAND SURVEYORS, INC. /j e V
‘ it/ff. 9001 BLOOMINGTON FREEWAY (3491), MINNEAPOLIS, MINNESOTA 55630 • PRONE E119.5311 -- O4e/it,
SIIRVEY FOR: _ t°tit. JOHN MAHONEY
Surveyor's Certificate
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Drainage a Utility
() Easements I g ` ;
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139. 78 I
J 1 ,I 1 SCALE: 1
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'° " I Monument
I hereby certify that this is a true and correct representation of a survey
of the boundaries of:
Lot 3, Block 2, PRIOR SOUTH, according to the recorded plat thereof
on file or of record in the office of the Register of Deeds, Scott
County, Minnesota. ,?
As surveyed by me this 25th day of April, 1973.
ei
,--sS .: .a . --.
Edward __ _ Sunde � _ H. Land Surveyor T�..J5
Minn. Reg. No. 8 �2_ PROVED
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guiiding. ; , # - ft
Zaning
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Gracing