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ti CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE , / 74—
0 r-4 AND UTILITY CONNECTION PERMIT
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1.White File
2. Fmk City PERMIT NO. `4 333
3. 3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
110%6 RuTGEA5 srtE r NC, P . LAKtr, slA) SS-3/2
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) ZACN 84A(0 (Phone) 151-Z'144"20I s
(Address)PiCEKp Qu40C45 ST NC, Pg.,0 it. LA ce, Lout A i s-s3 742
BUILDER
(Company Name) Nf/k (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction ik'beck ['Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish 0 Fireplace
['Addition ['Alteration ['Utility Connection
CODE: LLR.C. DLB.C. 0 Misc:
Type of Construction: I II III IV V A B WO
Occupancy Group: A B E F HI MR SU PROJECT COST/VALUE $ Z S00.
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 c. onn to all existing state and local laws and will proceed m accordance with submitted plans. I am aware that the building
official can revoke this permit f.r'ust cause. Fur:eijOr hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X
Signa e Contractor's License No. Date
Permit Valuation Z eC CI 0a Park Support Fee # $
Permit Fee $ P 3 r 75 SAC # $
Plan Check Fee $ 4-7_ (, Water Meter Size 5/8"; 1"; $
State Surcharge $ / 0 0 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—_6/
This Applicatloi. :ec.,ii e ' :uildingPermit When ' i prov i 1 14 1 ( `t�/'" j Receipt No. 71 z
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BuildingOirxial �- ( f/� n /(Y l`f'.,i,2,�.
This is to certify that the r�.1'st the above application and accompanying doc encs accordance with the City Zoning Ordinance/and may proceed as requested. This document
when signed by the City,er nstitutes�a temporary Certificate of Zoning mplian and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued.
�( r�
PlaluungDrec _ Date Special Conditions,rfany
24-Eour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
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PRIOR LAKEDEPARTMENT UILDNG O�INSPECTION
INSPECTI • N
RECORD
SITE ADDRESS /4P KUTC7FiKs
TYPE OF WORK DCK°
USE OF BUILDING fr�/e
PERMIT NO. 14Z33 DATE ISSUED S. 12.•14-
BUILDER 'Vie's! 00.14'I/7 PHONE # 657. Z1#0. 2415
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING 5- 1 -11('Y
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
IMMO*
• ( FINAL 4.161 )4
FOR ALL INSPECTIONS (952) 447-9850