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-of--ANt- CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMP ORARY CERTIFICATE OF ZONING COMPLIANCE
`� AND UTILITY CONNECTION PERMIT 5 - - ( r- a
I �
'v E 50
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1. White File
2. Pink City PERMIT NO. /3 , 3 93
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
L-- S f7 L I du ....,v, t l^� b ; d 9 , / A, c) , L -- i e. M Ai .c5 - 37L
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(N ame) 1 i m 4 141 °C In e k t' (Phone) ,/a - U ( i " yCZ 7
(Address) '-/��� )4-6, :+Amt'16 -d � c.-, / 4, - 0 , Ge- h ) / NN �'Sr372_
S
BUILDER
(Company Name) / n o 1 d (, c 7' i.. C9 X� r^ o 6'e- /' q S L 22 / 76 d L
J S (Phone)
(Contact Name) S c ) 'D ✓ et O / C n (Phone) 95 - z Z/ r 7606
(Address) / OG y 4 e j� u/5 A S $ 2 c.) , Lc. -.4e / I'm/ X5 . )
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re- Roofing ❑Re- Siding 30Lower Level Finish ❑ Fireplace
['Addition %JAlteration ['Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc:
Type of Construction: I II III IV V A B
Occupancy Group: A B E F 11 I M R S U PROJECT COST /VALUE $ jc-oc)U
Division: 1 2 3 4 5 (excluding land)
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 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 re this permit for j t 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 / 660, CJ-6 Park Support Fee # $
Permit Fee $ " 2 ¢" 75— SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $
State Surcharge $ SS-7) Pressure Reducer $
L
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 $ g 9 7 -
This Application Becomes Your Building Permit When Approved Paid Pj Cf 7S ieceipt No. (T/ e5:,
Date r. #, r 3
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 S.E., Prior Lake, Minnesota 55372
PRIOR LAKE
DE PARTM OF
BU ILDING ENT AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 5 / 4- i "' / f-16 e //L 27t �-
NATURE OF WORK 6-0-/EL-
USE OF BUILDING 71ETiV/7____
PERMIT NO. / S _ c- /-2 DATE ISSUED i 3
CONTRACTOR All14/64-0 &f) - PHONE 22-1 7c 66
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECTOR DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
111111111111111 —
FRAMING "JIMMY
INSULATION
ELECTRICAL
PLUMBING
—
HEATING ►'
A R NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
0111111111WW LATH
FINALS
BUILDING
ELECTRICAL
—
PLUMBING
HEATING
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