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4 PRIG
oc.) A �' CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
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`t TEMPORARY CERTIFICATE OF ZONING COMPLIANCE - J / /g
E� AND UTILITY CONNECTION PERMIT
Irl
kN S St51.
I White Fit PERMIT NO. 14 /1 d Li
3 Yell Celloe Applicant �1
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
131,-11 DroOVL:= Urck t /
LEGAL DESCRIPTION(office use only)
In �/'�
LOT `QBLOCK V ADDITION 3k/�SvW"e At �-� A`' A1 PID 4'5 0/6.. 04/1/'4d
OWNER \ 1 ���y�
(Name) Joe)t1►�d I Ittn Ci cm lC/ (Phone) °152_-620 -6115
(Address) 52T1 . .rU O V- G i r CUL
BUILDER r�
(Company Name) 0I1 V1 C\ GOn r I CrkU( In (Phone)
(Contact Name)) p 9�\I m� S f,�1 CII V (Phone) J& I -21i-- -31LD
I- VS-
(Address) B C'Icor90 Cu • `I I? 01Ilti i MN s 5I 2
TYPE OF WORK ❑New Cons. ct'•n EDeck ['Porch Cite-Roofing ❑Re-Siding ['Lower Level Finish ❑Fireplace
❑Addition -�214(teration ❑Utili Connections p p (��SAX
CODE: ❑I.R.C. ❑I.B.C. 9n�r-eo 1 L Mis Sly. 1,Ct 1 v1 I Ch CA
Type of Construction: I II III IV V A Bj�
Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $
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 cotistruction 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 revo
his per t for i se. Furthermore,I hereby agree that the city official2.C. 0)0501 / /7,.,y
oa �
or a designeenemay enter upon the property to perform needed iinspe tions.
/L
/' Signature Contractor's License No Date
Permit Valuation 2. tst Park Support Fee # $
Permit Fee $ . .;'7+S', SAC # $
Plan Check Fee $ Al JL Water Meter Size 5/8"; 1"; $
l
State Surcharge $ 'l t ` 1�Gi Pressure Reducer $
Penalty $ ,.-� Sewer/Water Connection Fee # $
Plumbing Permit Fee $ _-4 Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE i C�i tw.t 5, 2"L A 4 $ r 17_ r 1
f
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This App •ti NI:ec/,t es Your Building Permit When p t,.ved Paid / 77./9 Receipt o j17
girl _ Date 572/b By ' _ J-
:ud ing Officta- late
This is to c-rtify at th-request in the above application and accompanying do ents p in accordance with the City Zoning Ordinance and may proceed as requested This document
when sig bb ie
Ci. Pltnner constitutes a temporary Certificate of Zoning..mplia e and allows construction to commence Before occupancy,a Certificate of Occupancy must be
issued.
de
_. P aiming Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
.. /*"..
,
0 Q P Wpb Date Recd
CITY OF PRIOR LAKE PLUMBING PERMIT •. (' t f
� ofss
I.Blue File PERMIT NO. -r.}�.
3.Gall City � 1 ' J/ _
3.Yellow Applka o 1 4'[.�
(Please type or print and sign at bottom)
ADDRESS ZONING(orrice use)
i
17 0;-1 1 --"VD rt) 0 i1'i1 i' C.A ,C.St A 1
LEGAL DESCRIPTION(office use only) •
LOT BLOCK? ADDITIONS�O �Vi d/h 2/ /4c/iv pm -O/ - V/-0
- i
OWNER. ��
(Name) C/�l/` Q.�. 1 �� I (Phone)
(Address) 50-w`e
APPLICANT�j -
(Name) f)ri fl p[ufvt.10LN (Phone) -76 3 (9 /�1 "-1-I61, 3
Address 1 1 LI 3 C II ' . % tf
(Address) (City) (Zip Code)
(Contact Person) ' SA 6 1.Gt_.I1 (Phone) 1 3--6/ Y' 7/6
APPLICANT SIGNATURE A.. i J GYl DATE 4 (! -I/If
APPLICANT PLEASE COMPLETE BELOW
Quantity Type of Fixture Quantity Type of Fixture
I Bath Tub with or without shower Rough-ins
Dishwasher Water Heater
Floor Drain Water Softener
I Lavatory(Bathroom Sink) Stand Pipe(Washing Machine)
Laundry Tray(1 or 2 compartment sink Sewage Ejector
Shower Stall _ Backflow Assembly
- Sinks Backflow Assembly Test
Bar Sink , Lawn Sprinkler
1 Water Closet(Toilet) Other
FE Ti1e Miltnesota Sta.ttltes§326-B.1'48 Lint;cost with$49.50 minimum Residential,New One&Two-Family $149.50
"SURCHARGE"has been extended - i Residential,Additions&Alterations $49.50
The minimum surcharge for a
"fixed fee"permit is$5.00 S Building Permit#
-PLUMBING PERMIT FEE $ `I r'J - CD I�
STATE SURCHARGE $ )004 5 11 - "' '
ii
111
TOTAL PERMIT FEE $
(Office Use Only) 5-14. S� WG � � �
This Application Becomes Your Building Permit When Approved < Receipt No.
r �(j
Date ! I Sq By
Building Official Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245 - i.AA-------
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
,
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 52- --t R Q c'- C i2 C -
NATURE OF WORK -t, 4. R-- a��_
USE OF BUILDINGS fz-
PERMIT NO. (4-Q-- DATE ISS D 57/4 CONTRACTOR 6,\1�4N� �5 ,uc,-ro®\) PHONE 65f - z3i (n,
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECTOR DATE
111111111111110
0
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
iirldilagineninePTIC
FRAMINGL. 11) ,L►
INSULATION < < _ 6_ � , It(
ELECTRICAL
PLUMBING 1_ )L.
HEATING
ANIONME
R TEST
DER
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
FINALS
allIMMIWPRIOR TO SODDING)
BUILDING ` -1) 1 1 y
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