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Building Permit 10. 0583
l i PRlp CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd :,' , e TEMPORARY CERTIFICATE OF ZONING COMPLIANCE %< x AND UTILITY CONNECTION PERMIT U t M, N'NESO�P I. white File PERMIT NO 3 pink City 1 o - CQ 3 Yellow Applicant .7 0 (Please type or print and sign at bottom) ADDRESS ZONING (office use) L / c 0 D A ) Ci A s4 - LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER W ti t ( l I Y✓1 2 feg (A 0 1' W jw (Phone)9 — /6S. — S6(// / (Address) c ? j . 0 � � C} � 0 - FA St . OT 16 f 1 A �. BUILDER 1 7 1 C `� r a �` ) 75) �/7' 3? (Company Name) / d m h (Ph one (Contact Name) J 1 YYt S c 11 ( A- oz E- ( (Pho ) (Address) 3 3 G S t~ ,,,.. y,--, } L ,/ --I, 5 L TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re- Roofing ❑Re- Siding ELower Level Finish ❑ Fireplace ['Addition ❑Alteration EUtility Connection CODE: R.C. ❑LB.C. ❑ Misc. / ,.....e..--. Type of onstruction: I II III IV V A B PROJECT COST /VALUE $ ( d v Occupancy Group: A B E F HI MR S U (excluding land) Division: 1 2 3 4 5 1 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 abo e.ed property and tha 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 of icial can revo•.° this permit for st cause. ,.re, he eby agree t.: the city official or a designee may enter upon the property to perform needed Inspections. X — - -:_ o 13 l 4/o - —/o Signature / Contractor's License No. Date Perm Valuation Z 500. — Park Support Fee # $ Permit Fee $ —14.15— SAC # $ Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $ State Surcharge $ 5 _ — 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 $ 11 . 15 This A i ti ' Becomes Your Building Permit en pproved Paid f Receipt No. �0� _ II ■ 7 7/ (U Date `j12,�(E� By4 Building Da This is to certify that the request in the above application and accompanying doer ment is in accordance with the City Zoning Ordinance and may proceed as requested. This document when si by t City Planner constitutes a temporary Certificate of Zoning cc plia cc and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued 7 O Plan . Director a ate Special Conditions, if any 24 hour notice for all inspections (952) 447-9850, fax (952) 447 -4245 4646 Dakota Street Prior Lake, MN 55372 �css I N D , - � Scott y, MN wi,..,o p ` E - r1 t,J. 8`Fj�,i pRO Count- _ _ '' V 9C� S P ►svx r 3 4 ' 'e ve: a ,,..., q ,+ n fix. �.as�E ..•,--•,•- t: s i 4 3 19751 � � . di A ` , ,a • ,.• • • •,: ':/ mig,3:;:;,' 3 � A , ...., ..: '...''''',.,'; :.;,.i*l k r ,' ''.11:' ,.. . 0,4 '. .. : CD ms s ..., xw , Q PERMIT l° SS I � i � - . • ri : :. A $T T s,. rVQTED M Scal 5 11101Ce 11 ... .." ` ° � ' `r; = -' 1e' l t a. :MIT p r�etectors shall be : to � in � - r r .uay, an st ate offices an 1 inch = 32 feet ' _ . . - e „ n : o don in all i• rooms, lcliiw41cohcastedtory, s . r - i accuracies h a in= - ,, , ,. , . - .- r y o tai° flode rn- Map Date An lll • • , - - f 7/2/2010 S J" PRIOR LAKE DEPARTMENT OF BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS 43C0 D9-IG 'A- S TYPE OF WORK 4t cc-4) USE OF BUILDING 2 S A I PERMIT NO. CO ° 3 DATE ISSUED `7 Z (© BUILDER PHONE # -537+ NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT INSPECTOR DATE 1 1 PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED FRAMING 1 1 FINAL 1 1 FOR ALL INSPECTIONS (952) 447 -9850