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Building Permit 13. 0964
E 00> 0 000000 11 o > � n 0 00 0 . g ) k § M 00 z m§ 7 � c0 m m n o § ` K 2 m m § 0 _ > z $ § 77 ■ qq 2 0 - 0 z 3 o KS . t § k .. 1 § / \ k 0 n ` • z 1 n x -Ti ^ \ z k » 0 3 � S % / xo 0 \ 000000 m m $ 13 ® * m om 0 j o o \ \ n I 2 § § § / 7 \ -n§ m § 0 z' 2 m § § 0 n a r -noo § = E q _ \ z °\ > cc z r t z § m �� p § NA / § M \ > \ n 1 .... k j \ OEEOO l o q z \ I II§§ ° 2 , R. >0 0 c -013§ > Z ��� o m 0 ? rn r n ' . m 'x' �x F § cpz z \ w r 0 of PRI CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd y TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT En y /EvNESO�� I. White File PERMIT NO /3 _ 6 9 6v_ 2. Pink City / 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) 19 1c Asrvs. A e LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER // )) 9;_c (Name) o���, (IAA t C/ ! (Pho .=-_ L" (Address) BUILDER y (Company Name)) r -1� j © c y ,� (Phone) j 7 0 -7 1 ), (Contact Name) Air__ s-. / , (Phone) (Address) _- _ � ! . _ ,e,... �® 4 7 1 C TYPE OF WORK ❑ New Construction DDe k DPorch2 Roofin DRe- Siding DLower Level Finish ❑ Fireplace ['Addition ['Alteration ❑Utility Conne ion CODE: DI.R.C. DI.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 51 I I hereby certify that I have furnished information on this application which is the best of my knowledge true and conect. I also certify that I am the owner or authorized agent for the above - mentioned pr eery and that all constructio conform to all existi g state and local laws and will proceed in accordance with submitted plans. I am aware that the building official can revo is permit fgrjust cause- Ft the re, I hereby agree tha, the city official or a designee may enter upon the property to perform needed Inspections. X ., A.------" 4 3 6/�-, 7 9 r- ✓7 Signature Contractor's License No Date Permit Valuati Park Support Fee # $ Permit Fee $ SAC # $ Plan Check Fee $ 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 $ 3 /7'�j 7 g / / This Application Becomes Your Building Permit When Approved Paid pi' 7s Receipt N.. #.4, p , f b �— Date 1 B y ....14.., / 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