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of PRI° CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
0 F > TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ` /0. 1 Z
.. AND UTILITY CONNECTION PERMIT
v In
40,NESol) I. while File PERMIT NO / , 903
?. Pink City /
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS 4430 lz 4- AIc p U r L..okc, ��✓ S _ 5 ' 72 ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER (V �. 1 4 A d et ttt� K Zoo -
(Name) Ted-td/1f' (Phone) /. v e i 9i C✓Ire
(Address) 54i41-Q
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 'New Construction ['Deck ❑Porch ❑Re- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace
['Addition ❑Alteration DUtility Connection
CODE: 1}I'.R.C. ❑I.B.C. XMisc. 9 itr" L
Type of Construction: I II III IV V AB PROJECT COST /VALUE $ 5 oV°
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5
1 hereby certify that I have hirnished information on this application which is to the best of my knowledge true and correct. 1 also certify that 1 am the owner or authorized agent for the
above - mentioned property and that all const - iction will c nform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official ca e this permit for t aus urthermo , I hereby agree that the city official or a designee may enter upon the property to perform needed mspee lions.
X req � 8 6 , 1 i Z .
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
7—. ° Oa_ ®
Permit Fee $ t 4� SAC # $
Plan Check Fee $ 3k A l 1 • 15 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 $ SZCso _ (c
This • lication B • co • s Your Building Permit n Ap roved Paid v -/5"
/J eceipt NO.�� �
/ / / & Date 7./. `li
Buildin Of'cla Dat t
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
9 — 7-4 . G eGfrni,,,e.,.," Site-I
Planning irec 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
O) PRIple
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White - Building
�, �P Canary - Engineering
LANES° Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED ` 2 Z
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ v
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Accepted Accepted With Corrections __
Denied c�
Reviewed By: Date: / — 7 - 4.2 /0 0" ---
/4/1 Comments:
De-e l - Adler)/ 64 4 e C r - i LT_ pe- - l l zest '4)—
1
5 epe�r e . A v y; q i, f t rte KV a
—
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
c) PRi
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White - Building
yI P Canary - Engineering
n'NES° Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ., t/ 3 0" 0 tDc- ''c.-
APPLICATION RECEIVED /Gi / L.
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
44 .---)---.-- .
Accepted `�
Accepted With Corrections
Denied ''
/ p 5
Reviewed By: ` bi'`"�,� Date: �Z--
Comments: C o "'`'e'er 6 ,. 7 ate✓ 41.4 71 -C`+' '51
� 4t r-7—,-
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
PRIOR LAKE BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 4e 4 k
NATURE OF WORK
USE OF BUILDING -s ea-
PERMIT NO. C2- K 3 DATE ISSUED (42.-
CONTRACTOR & t,\-n/ ttr, I c PHONE C.,Si
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING J d) 7N/ 1
I FOUNDATION (Prior to Backfill) 1 " „' /p 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING hvor`1 bpdt. 1 z I311, rZ,14 17AL z/4 Z
INSULATION 1 1-1-)3
ELECTRICAL
.IMM€
iliiarlin44 required)
E
M,IR TEST ,31-14, L►t46 Ai T6g- 4/z0 ��=� 71556
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I 1 - iA w (ZiNe. r i) 1
FINALS
GRADING (Prior to Sodding)
BUILDING � 2// ly
ELECTRICAL
/-J
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must 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