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of PRto CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE , /3.13
Z.-.) AND UTILITY CONNECTION PERMIT
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44N ESdie. I. White File
Pink Cit PERMIT NO. ` l 2
3 Yellow Applicant /
(Please type or,print and sign at bottom)
\ADDRESS ZONING (office use)
I Li R(of / 3fo C, 2Z-
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER f j
- (Name) 6 013 V _('n -ke_ (Phone) 6(0)- - S -E"D
(Address) � A - YY/
BUILDER �
(Company Name) .� let i I, 0-6/ ' •, , ✓� p ��'' - 7 `
- ` (Phone) ` 9 a " 3 / 70
(Contact_ Name) 3 f S C t7 f'i'b / t (Phone) lam/ a- - 36 °/ — 5�1 a)-- -c , ette...
,, 41 /9,3 e x,049,1% ,,.' r 35 )
TYPE OF WORK ❑ New Construction ['Deck ❑Porch DRe- Roofing DRe- Siding ower Level Finish ❑ Fireplace
['Addition DAlteration DUtility Connection
CODE: DI.R.C. DI.B.C. 0 Misc.
Type of Construction: I II III IV V AB PROJECT COST /VALUE $
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5
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 1 am the owner or authorized agent for the
above - mentioned property and that all construction will confo,lri 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 . .. t for Just cause urth re erg .y agree that the city official or a designee may enter upon the property to perform needed inspections.
:Mg
ignature Contractor's License No. 6, 6D - Date c 9 , - / -(3
Permit Val ■ ation 1/ Opp - 67-D Park Support Fee # $
Permit Fee $ 8 e -7 Z5 SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; 1"; $
State Surcharge $ Z GZ.) Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ 5-1 , 5 Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ 3 # 73 TOTAL DUE $ 7 9 2
This Application Becomes Your Building Permit When Approved Paid /9 ?i (- 1 eceipt No. 6 ,72
Date , /3. a y
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
4646 Dakota Street Prior Lake, MN 55372
P RIOR DEPARTMENT OF
LAKE BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS /74 ///6.4,- -SS /42 6,- d-m
NATURE OF WORK i„-01A-it e--- t V _
USE OF BUILDING � ' /
PERMIT NO. /-3_ /2-- DATE ISSUED 2- Z. 13 . (3_
CONTRACTOR j,t/ic --0 PHONE 6 -3-6 __
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
isms ii- 10 Si I
lamermismagii...1 I
PLACE NO CONCRETE UN ABOVE HAS BEEN SIGNED
ROUGH - INS
grailliMINSIMEiiiiial
FRAMING/ / -22 -J3
INSULATION 0 _
ELECTRICAL
PLUMBING ` - 27.-0
HEATING (if required) 3 71,-I3
F I R E P L A C E 3 - 4 2 , - q ,
f A l GAS LINE AIR TEST 1 `)- -"
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1 I
FINALS
i llINIIIIIIMMINIIIIIIIIM
BUILDING (,) U 4Z243
ELECTRICAL
PLUMBING ViC04A 5227;3'
HEATING
DO NOT OC PK N ABOVE HAS BEEN SIGNED
r w
00“-ei ( NOT I CE
Thie a nd Mint be posted near an electrical service cabinet prior to rough -in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447 -9850