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Building Permit 11 0087
E 0 O n O OQO0 ' o> $g § 7121 k . i m c k k m 73 7i m dO §B Z§ 4 ■ ■ 00 � z § ■ % Co . § 0 0 q x o z m m % ; 1 o ` 2 13 If k i 73 k k 000000 1 X § m m �r� ■ § o o nc -1qc % 2 2 § ■ §$§ m o, 0 § q m \ 0 . > 0 § • $ 0 ? Z r ZX7 Z J r § 2 $ � �� o k o m k 0 ' g 2 000000 ! 4,. m oiin2 § a. 0 0 Wmm lo © \ 0 >m m 5-i-_2_�F k it z -I r 0 of PR CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd ,, c TEMPORARY CERTIFICATE OF ZONING COMPLIANCE I AND UTILITY CONNECTION PERMIT 2 Y P U t Ml i'N ESO '. White File NO . / _i 2. Pink City / /' ,e 7 3 Yellow Applicant Please a or print and sign at bottom) ADDRESS ZONING (office use) i ''7 / D 62Letefik C;l‘C1(4 LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION PID OWNER AA U (Name) ifi ) Q (Phone) (Address) BUILDER (Company Name) c :7-.-1 tae4- ti-- -t LL( (Phone) (Contact Name) %g et -Pt'-._-_.. (Phone) Zola 3 my (Address) 91'x00 i - - < j' /,(' 1454 14L4..._ TYPE OF WORK ❑ New Construction InDeck Porch ❑Re- Roofing []Re- Siding ELower Level Finish ❑ Fireplace ['Addition ['Alteration ❑Utilit Connection CODE: DL,R.C. DI.B.C. O Misc. Type of Construction: I II III IV V A B PROJECT COST /VALUE $ Occupancy Croup: A B E F H I M R S U (excluding land) Division: 1 2 3 4 5 I hereby certify tat 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 building official can revoke this ermi or ust cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections X ' Z © 5 .7 7 2-- - - Wl ( Signature Contractor's License No. Date Permit Valuation Z 00D. OD Park Support Fee # $ Permit Fee $ l / Z 2,-c-- SAC # $ Plan Check Fee $ U! r-� Water Meter Size 5/8 "; 1 "; $ State Surcharge $ / e/D Pressure Reducer $ Penalty $ Sewer /Water Connection Fee # $ Plumbing Permit Fee $ ,..5y 5 -7) Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer & Water Permit Fee $ Other $ Gas Fireplace. Permit Fee $ TOTAL DUE $ � , / /�f� Al- p � This Application Becomes Your Building Permit When Approved Paid - 2S Re pt No. - et , / Date Z, 9,, ( ( B , Building Official Date This is to certify chat 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 Residential Building Permit Checklist B amilyHomes BY: / Date: 2 , / Building Permit # / / 07 PID: Zoning: Site Address /4216 c12 a_e Legal: L B Subdivision: Existing Structure: YES NO CONFORMS TO ZONING YES NO ORDINANCE YES NO Is this an expansion of the existing footprint or Refer to Planning building height? Is the property located within the flood plain? Refer to Planning Does the alteration include any additional kitchens? Refer to Planning Does the proposed alteration include any outside Refer to Planning entrances other than patio doors? Is the proposed use of the finished space or Refer to Planning alteration for anything other than a normal single family home (office, group home, day care, etc.)? THIS CHECKLIST MUST BE COMPLETED AND INCLUDED IN THE BUILDING PERMIT FILE TO MAINTAIN A RECORD OF THE REVIEW. L: ITEMPLATE\ALTCHCK.DOC • PRIOR LAKE BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS /¢216 A■.„ & NATURE OF WORK Lo$+I ■ USE OF BUILDING �i� / PERMIT NO. E ISSUED • •1 / CONTRACTOR PHONE / WL 6 534. NOTE: THIS IS NO A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT INSPECTOR DATE 1 1 PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS FRAMING a/ 7//1 INSULATION ELECTRICAL. PLUMBING V(S,v.l HEATING (if required) COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED 1 1 1 1 FINALS BUILDING /A 7 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