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PIS o a 0 a 0 000❑❑ 0 1k0 ❑ —`
OF PRJ�� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE G�
AND UTILITY CONNECTION PERMIT < - Z¢
U Ili ,'i 13 > t. White File PERMIT NO. / j 7o 3 1-
2. Pink City
3 Yellow Applicant
Please or print and sign at bottom)
ADDRESS ZONING (office use)
3 36 1 m a\ corn C-4 SW
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID S. 4467,- 0 17 .6
OWNER ktV e L 962 3q3 - B 73)
(Name) (Pho
(Address) 336::7 Nod co IM 0.-4- 8 W , Pr o r 1- kQ MA)
BUILDER p
(Company Name) Il �, 1 GA 1"S (Phone) 44 S Z t Zc -9(4
(Contact Name) RO 1MA11 CkaivaIn (Phone) 1 4 52'
(Address) 1Z5 22 Cr re y L c C.4-- ft Vealki /.A) 55 ,24
TYPE OF WORK 0 New Construction Deck ❑Porch DRe- Roofing DRe- Siding ❑Lower Level Finish 0 Fireplace
❑Addition ❑Alteration ❑Utility Connection
CODE: [.]I.R.C. DI.B.C. 0 Misc.
Type of Construction: I II III IV V A B ��rr .Slk� •
9 9
PROJECT COST /VALUE $ O�
Occupancy Group: A B E F HI MR S U (excluding land)
Division: I 2 3 4 5 1
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. 1 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 pe it for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform neeV 24'J13
spections
X tic& 30 50a
cure Contractor's License No. Date
Permit Valuation Z700 d _o 6 Park Support Fee # $
Permit Fee $ / 73 ? f SAC # $
Plan Check Fee $ 4 9.1— Water Meter Size 5/8 "; 1"; $
State Surcharge $ r, v D 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 $ / Z Z , 7
This Application Becomes Your Building Permit When Approved Paid !2 P ceipt No. '7VU FO
Date 7 7 *s3
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
7
P RIO R LAKE BUILDING AN INSPECTION
I NSPECTIO N
RECORD
SITE ADDRESS 3.7407 nilf•e•etef di.77
TYPE OF WORK
USE OF BUILDING /241;:r 4W,..
PERMIT NO. � I3. �� DATE ISSUED ,�,�. I.3'
BUILDER Q ird/weies PHONE # aSZ...174.44140
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
- v, mox, D E
FOOTING ��`�irdfgll.�n��
PLACE NO CONCRETE UNTjr• HAS BEEN Ir
FINAL l / 2
• , FOR ALL INSPECTIONS (952) 447 -9850