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Building Permit 13. 1216
i J a , w 02 laWy 0 Q Q: p U u. u. 0 = Z 0000❑❑ > V O O O \ 2 N � Z j Z m 11.1 c O 4C 1 F- rg o � J o F V X X CC z_= =zz � a V S N v a �iw� v a z J W� J W h • O aX3coaX V W W W W ' 000000 8 00 a ce cc o � 1 z � ILI lii o o a o \h o z z 0 p ui y< 3 �� of a� y O za z W H o v \ u. W a' W 1= z.� 2 Y ce LU IX cc Z y a' cc V ` CO a U W W 0z 4 0 a 000000 0 0 0 c �. of PRIp. CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd ,, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE fe 5D ., l3 v ; AND UTILITY CONNECTION PERMIT 44 1vES��� I. White File 2 Pink City PERMIT NO. / 3, /2 /6 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING (office use) SV / gin e c C 44./0v4 ii2• Al, L / eve_ te "! 55 37 Pa.6 LEGAL DESCRIPTION (office use only) yy .. LOT / ADDITION Alj A/We 't 144 N PID 0 75- v7 /S t95-4-6 OWNER (Name) J1/ 44 L1 7g44- 9C., (Phone) (Address) .S' tcS elt.s At did' BUILDER (Company Name) S61 i✓ ' '-'s^. LL C (Phone) (Contact Name) f _"SaA -t ys/ (Phone) 61 - 7/ e " 36& (Address) /70 r...,,,-rt T 4.ri -R, ,uY/9 i ,7 N 5 6 • TYPE OF WORK ❑ New Construction ❑Deck ❑Porch K.Re- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace ❑Addition ['Alteration ['Utility Connection CODE: ❑I.R.C. ❑I.B.C. ❑ Misc. Type of Construction: I II III IV V AB PROJECT COST /VALUE S d�p0©O 0 v 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 building official can revok s permit for t use F hermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. x ,ac 6-3 '10 79 /O/7o1i-3 Signature Contractor's License No. Date Permit Valuation Park Support Fee # $ Permit Fee $ 2/-111C SAC # $ Plan Check Fee $ Water Meter Size 5/8 "; 1"; $ State Surcharge $ �/' 5 -7 Pressure Reducer $ Penalty $ ` 7 (J 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, 5 This Application Becomes Your Building Permit , en A ■ oved I Vv` Recei • t No. Ar i / 0 ' D to ' 30 (3 By / . uiiding zip al 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 A