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o1 PIZ%% CITY OF PRIOR LAKE BUILDING PERMIT, Q/ Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
U x
AND UTILITY CONNECTION PERMIT .3
44NN EOlt. I. White File / 2 "`�
2. Pink City PERMIT NO . ')
52_
3 Yellow Applicant t� ��JJ !ll���"
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
'7312 beeKe i F Lo b f. s E
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER , '1
t l'
(Name) A-2,/ 4- U N ti F 1/t' r c (Phone) Q 5 a (0 ` r i 0 3 S—
(Address) / '731 V- 'b e 2 p (F. L b 2 St.
1 BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ((Deck ❑Porch [Me- Roofing DRe-Siding ['Lower Level Finish ❑ Fireplace
❑Addition ['Alteration ['Utility Connection L ' �-
CODE: I.R.C. ❑I.B.C. YMisc. _116:17 r/67 H) 0 /7 A cy.
Type of construction: I II III IV V A B PROJECT COST /VALUE $
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5
1 hereby certify that 1 have furnished information on this application which is to the best of my knowledge true and correct. I also certify that 1 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 c.n revoke this permit for just cause. Fuithe - more, I hereby agree that the city official or a designee may enter upon the property to perform needed in: cent "
X � ti ._ I F 5/ <5 i e ,
1 J o ture Contractor's License No. Date
Permit Valuation Z. 0 00 , 0 0 Park Support Fee # $
Permit Fee $ 7 , 7 SAC $
Plan Check Fee $ I 7 9. Water Meter Size 5/8 "; 1 "; $
State Surcharge $ r. 0 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 exitsy) x5,7.12. $ /2--Z- . (07
This A2- ica • ,n Becomes Ybur Building Permit en pproved Paid r'a-Z, 4s Receipt No. �Dc7
A ' / Date 5lei , By in
1'.4 _As s 7 t z �
, 'tildin 1 °. 1111.11111. D, to
This is to certify that he request in the above application and accompanying do ume s is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when sig • y th ' ity Planner constitults a temporary Certificate of Zonin. omp ance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
L 41/1/AL L
4
r • lanning - Date Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
PRIOR LAKE BUILDING AND �NSPECTION
INSPECTION
RECORD
�
SITE ADDRESS / /3IL DEW/52,0 DAL
TYPE OF WORK Dag"
USE OF BUILDING aengit
PERMIT NO. IZ 352. S
DATE ISSUED
BUILDER IWItFITE PHONE # 1,241. 7635
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING r17) S (N 1 f
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I ~NI 1 I 1
I FINAL 1 ffb
FOR ALL INSPECTIONS (952) 447 -9850