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Oti FPint CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE z7 /3
3
AND UTILITY CONNECTION PERMIT
�r�xesotr I. White File P PERMIT NO . °�
Pink Applicant y
3 Yellow Applicant ' ® "
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
��
/(93/ /VE. k/
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID 2. 31, 002,6
OWNER
(Name) _ 4 2. If 45 t,i-- L, L e' 714 `i 6-7-.e ‘'F (Phone) 9 ' 2W S r
(Address) .2 13 . I e e " p i e a w / / 1 1 S 4 4 A‘3 ( /4 /V ..KY 3 7 y'
BUILDER
(Company Name) (Phone)
• (Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re- Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility C onnection y
CODE: R .C. DI.B.C.
isc. ,Z / x Z G l .
Type of o I II III IV V A B PROJECT COST /VALUE $
Occupancy Group: A B E F II I M R 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 hue 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 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 ig,ee 4 - Z ? —i 3
S ature Contractor's License No Date
Permit Valuation r at' UD r -- Park Support Fee # $
Permit Fee $ ( P 1 • ---N-- SAC # $
Plan Check Fee $ 1 Co.. Water Meter Size 5/8 "; I"; $
State Surcharge $ 2_,, J 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 $ l 6 , r 79
This A , i l' ' . ecomes Youl`Building Permit • en Ap . oved Paid irmv,_ Recei. t ►, .. 'MOM
Date By 414
L. .- i t 2 r
Built'ing °tiicta Date
This certi that the request in the above application and accompanying ..cements is accordance with the City Zoning Ordinance and may proceed as requested. This document
whe 'g ..., I
AL e City Planner contrtutes a temporary Certificate of Zonin, complianc and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
iss / z
r Plannin l Directo P ate - Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
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LIJ$ TUFF SHED' BUILDERS iHELPER FORM
,customer: 9? I I/4 C., ( l.Mye i 1 Date: i 27/ ? ,, 1 Invoice*:
Home Phone: P
Altel'nate Phone: i tu c t a i
Work Phone: •
QUESTIONS FOR CUSTOMER
Wilt customer or responsible party be at the site at time of delivery? I n r t a
NO
Length of carry from truck `75" FEET 'Clear access to site? NO
Is there 18" 24" for Tail Barn of dear works = ce on all sides of buildin . site? ►" NO
Is site clean and level (see Site Leveling brochure for explanation)? "Zgarli , . ._' f ' 1► NO
Customer will .. • e 110AC 20AMP electrical service within 100 feet of build site? 0 NO
Does the pathway from the street to the building site contain any sharp tums or areas less than 3'w x 9'h? • o
Building permits, fees and at related costs of site readinesss are the customers responsibility? '. NO
Buyer understands that Building Permits and Engineering fees are non - refundable? NO
1 understand that any order missing information (I.E. - Will Call, Door, Window Placement, Paint or Shingle 111 Color. Signatures, Down Payment, etc.) must be completed no later than 5 Working Days prior tQ NO
scheduled build date or construction of the building will be rescheduled to the next available open date?
Owner agrees to have the site inspected and prepared against tern* t_. _ --
I understand that occasionally, due to weather, usually rain, my build date may have to be rescheduled? NO
Customer will have balance due available to TUFF SHED builder at time of delivery. YES NO _
Final Payment By (check one): a credit Card 0 Check 0 Cash E] Other
Building Features: ),�lil
1 1
4,0 AkCee Pero "/ Reverse Views Reverse View
Yv r u� „--^
T ' 445
SIDE 3 , i 1 SIDE 4 -�� SIDE 4 1:1L
SIDE 1 SIDE P 14 I SIDE 2 SIDE 1 SIDE 3
10 ?&rr,>\ t LAKE
T DA P -i�
D SCE ' ► •- SUBMITTED
'' d tr rr PTED WT I CORRECTION, S AS NOTED 1
0 + + T AIOEPTE RRECT & RESUBMIT
SIDE 3 SIDE 4 v comments an tor-you n. Alt wort shall be ddne
SIDE 1 SIDE 2 requireth nts including item ggigsgecifiOetly noted in this reiik#w.
' KEEP THIS PLAN SET ON Sf rE AT ALL TIMES.
For Special Instructions and Directions to site, use back of this page. j
IMPORTANT CUSTOMER NOTICE
The sketches above represent TUFF SHED'S understanding of where you wish to place your buildings doors, windows, shelves, etc. Please review each of
the drawings. If the sketches are accurate. approve them by signing your name below. We can make revisions to the placement of certain elements of
your buildinii at no charge as long as you notify us at least 5 business days prior to the date your building is scheduled to be built.
•
Customer Signature: Date: k 4 7^
Thank you for choosing,.. diTUFF SHED .
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Scott County, MN
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Buiidin • Date
Zoning _I r'�,.....� Date.
This drawing is neither a legally recorded " N
intended to be used as one. This drawing is a compilation of records,
information, and data located in various city, county, and state offices, and 1 inch = 20 feet
other sources affecting the area shown, and is to be used for reference W —kw-- E
purposes only. Scott County is not responsible for any inaccuracies herein 1 -I.
contained. If discrepancies are found, please contact the Scott County Map Date
Surveyors Office. 6/27/2013 S //)&10:)tt