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CITY OF PRIOR LAKE BUILDING PERMIT, Date Reed
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L'.( ,/ \ \ TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / 0 . 2.- 2 - .. )3
t) k4. 1i ,._-_,L,, ,.:)'"
) AND UTILITY CONNECTION PERMIT
VIRISOPI:c
AWE so
'2' w iltr V,1 PERMIT NO. 73 7/7 --)/
3. Yellow Applicant
C ot print and. sign at bottom)
ADDRESS
7,____me_
.-.
E. L4 i
1 ( tee-K C4-. M E 11 to/ A l ifi. ) 6S1372_ ZONING (office use)
a v
LEGAL DESCRIPTION (office use only)
LOT /; ADDITION PID z-5 3,o,. 0357 0
OWNER . // 1 1
Mune) DX.22.: ''. 4. N et kl‘. t 1-1
(Address) 1 -(3,00 4„....,.._ C.1-,. ii . P,....„,„ , z....e_.
p /
(Phone) . q5 2 - gal - 6 ( -7
BUILDER i e•—•
(Company Name) L.0-rs'e k... C cit /Zee 0 vief t 4.1, — C_ . (Phone) " - 7'7 - .73/
(Contact Name) 1.-1 -i-i Lew ;--. (Phone) TS 2- - 771 - 339 ,
,-, .
(Address) C F5b C 1 efovti ? i r tii" t cv te nA) s-c 3'7 2-
TYPE OF WORK 0 New Construction Die& Ol'orch Otte-Roofing Olte-Siding $.ower Level Finish 0 Fireplace
OAddition 0Alteration Dutility Connection
CODE: D.R.C. 01.13.C. 0 Misr:
Type of Construction: I II III W V AB
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ I IC eel)
/
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have furnished information an this a . .11...anon which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent fire the
above-mentioned property and that all construction will conform to all existing state and local laws and will proceed m accordance with submitted Aims. I am aware that the building
.4. • , c vase f. . . - ,. '. just cause. Furthermore, I hereby agree that the city official or a designee may crater upon the property to perform needed inspections.
X Eh , WI' ; occ 76 1 9 1/ 3
r Signature Contractor's License No Date
Permit Valuation 3, 6' 6 C2 ,. 0 0 Park Support Fee # $
Permit Fee $ IV_ 7s--- SAC # $
Flan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ / 57 Pressure Reducer 5
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ 5 1, , 5 -6 Water Tower Fee # $
Mechanical Pennit Fee $ Builder's Deposit $
Sewer & Water Perron Fee $ Other $
Gas Fireplace Permit Fee $ b-- / s --p A./6.- TOTAL DUE ) ' : s/3 C. 75 -
i
This Application Becomes Your Building Permit When APProved Paid 7..? a- 7r Re eitt No. 70
Date . 70, 2- Z. . i c By V
Build* Official Date
This is to certify that the request in the above application and acconmanyirig 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 o( Zoning =whence and allows construction to eminence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Dliedel Date Special Conditions, rimy
24 hour notice for all inspections (952) 4474850, fax (952) 447.4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
DEPARTMENT OF PRIOR LAKE BUILDING AND INSPECTION
INSPECTION
SITE ADDRESS /450 i'VvSW e'er
NATURE OF WORK L W J P �IGiZ•
USE OF BUILDING / /"
PERMIT NO. /3 • ,/T7 DATE ISSUED /D. ZZ. /3
CONTRACTOR ZiPtibA/ /#)M 1SEM& PHONE dm.. ill miff
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I 1 1
SIONNIMMINIMIONO
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
iiNIMIXEMENNO
FRAMING ;/ l
INSULATION
ELECTRICAL
PLUMBING I� )1
HEATING (if required) i J� /� , �
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I 1 1 I
FINALS
BUILDING / it
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