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C �°�� , � CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
U TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 2
AND UTILITY CONNECTION PERMIT �, /3., �`�
���1V E5 0 �
1. White File PERMIT NO .
2. Pink City / 3 i 3
3. Yellow Applicant
(Please Type or print and sign at bottom)
ADDRESS ZONING (office use)
31(0't TA.N.l corn CA . • W
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID 25 , #94 0/ b - D
(Name) e) 1 Pr,Y1 4 M{, o c k y att, t (Phone) la \a, " y qqe 7
(Address) 33 (o M,A. ∎ Co ,n. ^ 1 _% - S.W .
BUILDER
(Company Name) ■ P t n G * (Phone) q S 'L - Z•c1Z (A O'"1
(Contact Name) c4 6S M. oc_ Ceto (Phone) (oC 1, — 2 $ 3 S
(Address) k312 1 cS ohA son )reNctn Or∎b.,•. 1) r. , Sh opu- )■s.t S3 - 1c1
1
TYPE OF WORK ❑ New Construction Teck ['Porch ❑Re- Roofing ❑Re- Siding ['Lower Level Finish ❑ Fireplace
❑Addition ['Alteration ['Utility Connection
CODE: DI.R.C. I.B.C. ❑ Misc:
Type of Construction: I 11 III IV V A 13
Occupancy Group: A B E F A I M R S U PROJECT COST /VALUE $ ` t QO 0
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 revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
x - C 1ST I i — 13--13
. e r. ,
�, Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ 0 e , ? SAC # $
Plan Check Fee $ 5 7 3 0 Water Meter Size 5/8"; 1 "; $
State Surcharge $ / 5 - ) 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 t/ - , L DUE t 19 , . N / 7 $ /47
This Application rues our Building Permit Whe Ap ved P TO aZi , Receipt No. 11 t
„0 / / /.j D , \ . \ D' 1 By Sl
Buildi g Official Date
This is to certify • at the
..e 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 C j a Planner nstitutes 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 no ice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
PRIOR LAKE BUILDING EA T
INSPECTION
, � R I �
SITE ADDRESS /�W GT
TYPE OF WORK
USE OF BUILD!
PERMIT NO. �'3� DATE ISSUED
BUILDER 4t=r�� VP . PHONE # , O
NOTE: THIS IS NOT A P RMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
1 ': ECfOR • ATE
FOOTING
PLACE NO CONCRETE UNT)O HAS BEE SIG
IFINAL 1 � I t z (z �i I
• FOR ALL INSPECTIONS (952) 447 -9850