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Building Pemrit 13. 0675
CD Zk u la z ■ j � ��_ Q \ �� < & LI �Z > 7 2ex 2 o2wbco z y 2 a / \ ES77o $ ? 000000 o R cc x § § W ® § k q k o z $ } § \ 0 E 2 § AMu . e m o§ P. 0 C S ¢ � 2_ ? ?77 u ; f \ � R d ww \ / _, © n ° 3 w ■ ag w w rx w 000000 ® § § E / o ) 2 0 < ° 0 \ u. W . . 1 0Q 2 Q 7 , § � $ -. Cd a / % E y b . I". « W # - 2 o k ok . � � � � ®§ .. ...1 W < ® W W # 4 § m R 2 K2���� § § § 7 © Q Ow W R R�2z� 0 0 0 a cn 0? « o a ODOeno § E 0 �u. u_ @�§ p = g U ` C ESO CIT Y OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT z " il" I . white File ` � 2 Pink City pERMIT NO (;,7s--- . 3 Yellow Applicant / _ (Please type or print and sign 4 bottom) ADDRESS 1e i 1 i Pat S ` ZON (office use) LEGAL DESCRIPTION (office use only) � ` LOT eg BLOCK 5 ADDITION P✓ /a,� / ,/^ " ' � 1)Q/�/ PID AJ' a 0/4/ ed OWNER t p (Name) (-Inn t /-L r k-/� / 11 ,( (Phone) (Address) Li g J t 'c, , Sy-. BUILDER — O � (Company Name) l" YY� yZC G� `� (Phone) ��? Z C u% Cr (Contact Name) S an h-ii/91 e ‘4- (Phone) (Address) tt3? 2. Z L- I-44, / ,/ LW--- J-/ P Yri p rC - TYPE OF WORK ❑ New Construction Qeck ❑Porch ❑Re- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace ❑Addition ❑Alters o n ❑Utility Connection CODE: ❑I.R.C. ❑I.B.C. ❑ Misc. Type of Construction: I II III IV V A B asz. PROJECT COST /VALUE $ ��� 4v Occupancy Group: A B E F HI MR S U (excluding land) Division: 1 2 3 4 5 1 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 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 can revoke t e - for just cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections - Signature Contractor's License No. Date Permit Valuation 31 . DO Park Support Fee # $ Permit Fee $ 88 . ,d5- SAC # $ Plan Check Fee $ 51 . 3G Water Meter Size 5/8 "; 1 "; $ State Surcharge $ (, 5-15 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 a► (;0 Le v1, (3 , $ 141 , I This licati B- o es Your Building Permit When Approved Paid -� _ ' ' ! !i.t No. .. gl�'� i 11IP Date /,niallillil " u . ru Iicial 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 PRIOR LAKE DEPARTMENT OF BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS 4 2J& TYPE OF WORK TEd USE OF BUILDING S/ b PERMIT NO. /3 ,6 DATE ISSUED Ce . Z 7 . / j BUILDER 7 611 vvC. PHONE # o 'g NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT ► e r i _ n ���`�' � � � -- Lo c4.4-; �- i c5 Gt } I�oa� + �� (/! � • INSPECTOR DATE FOOTING f . 1 - /' , PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED I FINAL 1 - 1 '1/7-13 FOR ALL INSPECTIONS (952) 447 -9850