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0 t". f PR�o CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE !a • � d AND UTILITY CONNECTION PERMIT
/ 2-46
4�Ntveso i White File Date Rec'd
City PERMIT NO. !2 , jL
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
u 07° JZ rJ LL ( 4 ST. .C& eis.D
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER j �, S a tJ ERA/ y�� , �O ilv 5 'S"z -x,83' 22 93
(Name) J 0 111 J (Phone)
(Address) SP 1i E
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ❑Deck orch ❑Re- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace
DAddition ❑Alteration 011 li Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ 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 conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the budding
1 official can re •e this i V - mit fo • ust ca�ermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
i /0/8 0° Z)
Signature Contractor's License No. Date
Permit V. . ation 8 000. _ Park Support Fee # $
Permit Fee $ 1 cp Z , — SAC # $
Plan Check Fee $ , o 5 ,- 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 $ 211. 3®
c...#44-.-. do 704 ,
This App ation B: Y es our Building Permit Whe Appro ed Paid r ,,2 . 7 / .7 O ceipt No.6 f Y $
Date iv, c .(..2-
Building Official ■ Pate
This is to certify th the reque: i' the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by t. uty 'lane ons • tutes a tem�rary Certificate of Zoning compli cc a • allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued /
/ '� IIIIII■ f J--',
Planning Director Da e Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
pEF�ARTMENT OF
PRIOR LAKE BUILDING AND IN SPECTION
INSPECTION RECORD
SITE ADDRESS 41 o 1 r cv
NATURE OF WORK ?, s t✓�s� - F gcb USE OF BUILDING g- A-/r --
PERMIT NO. tz- Izi 1 DATE ISSUED i o /5 /r2
CONTRACTOR PHONE qsz - 3 zz 3
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
FOOTING I Y,7 /4 /.z2 /
C
J-Jc (Prior to Backfill) 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEI=WATER / SEPTIC
FRAMING - o Fa,g,h ,P )2,
: INSULATION
ELECTRICAL
,- -PLUMB ING
'HEATING (if required)
ACE
— GAS - EINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
FIN ALS
G (Prior to Sodding)
BUILDING
/ y
ELECTRICAL
Y J v+
1441:1148ING
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