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PR /p CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
c TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
U trj AND UTILITY CONNECTION PERMIT ' l 7
41INNESd(! I. White File A f` 2 70
PERMIT NO
3 Pink City 1
3 Yellow Applicant o
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/603 Frank -lfn - Tr
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER (�
( Name) .� t?t'; . .:tv%.1 ,..✓Y'Cifr 1t (Phone) q5`:) LeLio. -3 6i q '7
(Address) 1� -D 6 07, 300 . 5q r
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction Deck ❑Porch ['Re-Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace
['Addition ❑Altera on ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc. •
Type of Construction: I II III IV V A B PROJECT COST /VALUE $
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5
I I hereby certify that 1 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 building
official can revoke thi permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X AC L % (' JA — q / -
Signature Contractor's License No. Date
Permit Valuation 2/ 0 Q 0 r 0 0 Park Support Fee # $
Permit Fee $ 13 • 73 SAC # $
Plan Check Fee $ 47_14- Water Meter Size 5/8 "; 1 "; $
State Surcharge $ /.. D C> 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 t $ f / Z Z_(d7
This •t ■ .1i . ion B comes Your Building Permit a Approved Paid / z .k / R pt No. tl G 72-0
Date L B `
i lia + 2 - -
. uilding Ofticia to
This is 10 rtify that the request in the above application and accompanying do ime is is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when sir/ by t . City Planner constitutes a temporary Certificate of Zonin om lance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued f
Planning ' 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
A DO
INSPECTION
RECOR •
SITE ADDRESS 4 P •
TYPE OF WORK I 417v
USE OF BUILDING
PERMIT NO. • D E ISSUED BUILDER akifi ' PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
(FRAMING
(FINAL I 1 1 `j- I ' i
FOR ALL INSPECTIONS (952) 447 -9850