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Building Permit 14. 0504
ur z 1 § � � E§ U11 � § 0 gra 2 � § § z k k aaaM 0 2 % _i � 0 ■ ww ■ 2 IA5 ��0 e ■ Ei 10 000000 > H � � � y . �� ■ 2. oILJ O. 0. w z / ■ OQEC -1 o d 0 - w k ■ to O O t < P .- w 0 0 w © re33 § � w ` $ 2 § ■ U a § Iw ■ x 0. 3 oc z _i 0I- o omi0 o § X a ■ ■ ■ a ■ !k w w §w k 000000 0. j I › o ■ LU z § o til o < R ■ ti 0 0 CP § 0 / a� ■ d 2k2 � & W © ow .J § U.0 2 ■ w oz ■ j <w - re re re 0 « § 0© ■ w z oore■ zi- 2 0 0 0 j ©eau. _ ■ o ■ u u a z o � 2 0 a. o000b0 C.) )c0 E 01 PRI04) v CITY OF PRIOR LAKE BUILDING PERMIT, v Date Rec'd 4.ANe TEMPORARY CERTIFICATE OF ZONING COMPLIANCE o AND UTILITY CONNECTION PERMIT _ `®, / .i."....... ,cy ivArEso 1.white File ty PERMIT NO. /¢1 ,..67) 3 — 2. Pink Ci 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) 5 1C-i C —)c1c kc�C'C-7 S*, c LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID 2 S • Z I Q . 4 Z Z- d OWNER 6S7 - 1? ^ _ (Name) �0-1-1 L -C �' 3h ILE (Phone) C�'`�S 1 1 C% c-) 1 c1 (Address) C. -+Th c� C C<:`CC` 3 IV c - BUILDER Company )---- -S.(c-C-1c4--,t.- ?,16‘`0,) ��L Phone _���� �- (CompanyName) �-'-� �� (Phone) '----)(c")c� (Contact Name) \ I l4 )�1Y\L�Ip1'i.-)1 \ (Phone) D 7�( )O� (Address) )L_)CC' f�<,--0i )\L W P 1'�moo m m\V IL 4 TYPE OF WORK 0 New Construction ['Deck ❑Porch �e-Roofing ORe-Siding ['Lower Level Finish 0 Fireplace ['Addition ['Alteration ['Utility Conn CODE: ❑I.R.C. ❑I.B.C. 0 Misc: Type of Construction: I II III IV V A B . c> Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $ P -1 Il , 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 tha Mt 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 t • p t fo st cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspe ons. Signatur Contractor's License No. Date Permit Valuation Park Support Fee # $ Permit Fee $ SAC # $ Plan Check Fee $ Water Meter Size 5/8"; 1"; $ State Surcharge $ 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 $ This Application Becomes Your Building Permit When Approved Paid 2 `�J- IC./ R ipt No. -I/S-4'C Date G. <c .,"-f B _ Building Official Date This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinanc d may proceed as requested. This document when signed by the City Planner constitutes 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 notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372