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Building Permit 13. 0249
' m ❑ 0 0 0©000❑ = 0 Av -c) 0 C7 0* 0 01 -n p 0 -o n - �zrn m m m r "O C r o 7i M 7 3 m r r - v 3z� m G1 - n r m m N m N �ZVZ p L' p -° ttti n -t D. m 0 0 0 Z O f0 - D N c n n z 0 z 73 C ` -I m -� O St 2c z O lo z / m 7 7 C m n l.�j tn 0 > z >, 0 A • x m . - Z 000000 O m 'T1 m m m m p n z o v ■ \ 3 r � N* 3 r `m c I m c Do ? N z3 mx - n N z o N m G) i T W ZZZEl 'o m 0 >G)00 m 3 --1 m -0 n n 0 r -n O O 70 =4 P C til 0 a 03 - ± - cc z ( r O Z m rm o O v m c. ., - 0 O m C 0 m 0 0 ❑ 0 ❑ ❑ 0 m t Z E 0mm0m . v R. D 0 �mm3� m • < 0 v-ov7p (A • Z D n n Z D 4 tl i 0 m m 11 � ; --I ,y m X m 73 r • N Z ..- Z m -1 0 Microsoft W - CITY OF PRIOR LAKE BUILDING PERMIT.doc - ... hftp://www.cityofpriorlake.com/pdVbIdg_permit.pdf 4 pR 0 CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd `` TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / 1 . ii. y AND UTILITY CONNECTION PERMIT r 1. White Ai: /3 s. link City PERMIT NO. 2 G , / 3. Yellow Applicant J (Please type or print and sign at bottom) ADDRESS ZONING (office use) :5k29 //1 7 (xe/Yz LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER �/ (Name) /Itt CXI /4)ei /"/ (Phone) (Address) /" /��C BUILDER c � igi " (.r jj (Company Name) � l`. �1��, (Phone) �/2 ,Z/ 9•W (Contact Name) � ( f 4- i10'E7W --- (Pho e) (Address) !L A C /C .�� - -/ _g :!/ ce ./ -r - '7 TYPE OF WORK 0 New Construction ['Deck DPotoh ['Re- Roofing >0e-Siding ['Lower Level Finish 0 Fireplace ['Addition ❑Alteration ['Utility Connection CODE: ❑I.R.C. ❑I.B.C. 0 Mix; Type of Construction: I II III IV V A B _ Occupancy Group: A B E F H I M R S U PROJECT COST /VALUE $ Z 170 Division: 1 2 3 4 5 (excluding l I hereby certify that I '� information on . application which is to the best of n r knowledge true and correct. I also certify that I am the owner or authorised agent for the above-mentioned pr.. .."y .. . . t alt construct • . , caafotm to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building affs:ian can revoke ., p .. just cause. P a ... are, I hereby agree that the c' • official or a designee tgnee may eater upon the property to perform nee_ ded pections. Signature Contractor's License No. ate Permit Valuation Park Support Fee # $ 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 Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer & Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL DUE ) $ This Application Becomes Your Building Permit When Approved Paid -79_ 7r R 'pt No. (. gCz4 Date J 2./_ /3 By . 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 by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be Off • "r Date Special Conditions, deny 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 4646Dakota Street Prior Lake, lUmnesota 55372 ,"" �► 1 of 1 / /% zs(j. e fir 3/27/2013 3:33 PM