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Building Permit 13. 0301
f O 0 n 0o0000 1 o» En n n k 000 . c * z § k n § r R A 2 X m ■� 20z z K � 17 § t / k 0 z ro § o ■ m© z 9 z xl K 2 5 3,1 � , k � % / > 0 e g CA -0 -0 % m 2 000000 q m q ' s7wsr 3. \ � � kE §M \k 13 o co 7 2 f 2717 ■zxs - z ■ z z �� % Z N � rk§\ 0 @ / 0 m ■ § z $ Z . . ! i-0 m 0 m k o S \ m n ....... -5 t § 2 •OOOOO z ). -- Jo§ P k R. o © so . O N \ 0 >PP \k 9 � k V r 0 Z e f P R 1p -� `Z � l./ CITY OF PRIOR LAKE BUILDING PERMIT, / � . ' TEMPORARY CERTJi KATE OF ZONING COMPLIANCE UTILITY AND CONNECTION PERMIT NNE Date Recd 2, Pink Cit PERMIT NO. r (Please type or print and alga at bottom) 3. Yellow Applicant /�� -�� �� ADDRESS ZONING (office use) > / 7 I 4 i /%�e V LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER aL A'�.L C� (Phone) 95 a - 4 qD — / 9 4/3 (Address) /4//g7 L / ` e di.,40 I �i� 1 �. N • 6,5 -7 BUILDER (Company Name) ! 1 .- \ . (Phone) (Q' l - i . 8 (4 - .- C 4 6 (Contact Name) = c 1 _ 1 g`is 4 (Address)14 7 44 . .. . , i . _ Avu -b O� TY N SSC 1u y. i Ns TYPE OF WORK 0 New Construction °Deck []Porch ORe -Roofing °A d iition °Alteration °Utility Connection g �Re Siding °Lower Level Finish ❑ Fireplace CODE: ❑LR.C. DLB.C. ovas, Type of Construction: I II III IV V A B Occupancy Group: A B E F H I M R S 1J PROJECT COST/VALUE $ / a/ i . v 0 Division. 1 2 3 4 5 (excluding laud). 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 ...1. and that an construction will rm to all edsting state and local laws and will proceed in accordance with submitted plans. 1 am aware that the building official can revo for just cause. Furth hereby agree that the city official or a design y upo uPo the property to perform nee • ons . - �� /7e4 e • Signa fje Contractor's License No. Date Permit Valuation Park Support Fee # $ I Permit Fee $ SAC # $ . Plan Check Fee $ Water Meter Size 5/8"; 1"; $ State Surcharge $ Pressure Reducer $ Penalty $ Sewer /Water Connection Fee # $ Plumbing Permit Fee $ Water Tower Pee ## $ Mechanical Permit Fee $ Builder's Deposit $ Sewer & Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL DDE $ 79 7.5 . This Application Becomes Your Building Permit When Approved Paid 7 , C _ 7r Receipt p d / Date 4 (e it 3 , By , • i Building Official Date This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be issued. Planning Director Date Special Conditions, if any 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 646 Dakota Street S.E., Prior Lake, Minnesota 55372