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Edi FRI04, CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
Z.%:"0:::::::::NI TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / 1 4-
AND UTILITY CONNECTION PERMIT
j&Ivaso� _..
1.white File ..ir /�
x Pink �;� PERMIT NO. //J
3.Yellow Applicant I , I((J
(Please type or print and sign at bottom) _
ADDRESS � ZONING(o�5ceuse)
\6 a40(0 4O1'(WWv Q liS C*o j T{Ol(' 1.44t .
LEGAL DESCRIPTION(office use only) }S L 1
LOTS BLOCK LI ADDITION\X}QA4iW )Gt r4 1 PID
OWNER ''� r ` -
.^Q.0
(Name) \�; k N'A % (..6.\4 - -V\n1(1"1"— (Phone) q& - 1')C1
(Address) \F tI LN(-0,r‘,01%,\ '1`1, ci\o
BUILDER �,,�
(Company Name) '1 1�C. \NO7N1(1‘P� �iry C_ - (Phone) CI IX' (A45-�5(1b.-(i
(Contact Name) 11.Z t'1 \IN`1tvtple,,h (Phone) Y1 l 1
(Address) On 731. `-Ilvm •Av i lw k '\a- C llnPrneyc 1 1t4 , Y-6`6n
TYPE OF WORK 0 New Construction ['Deck riftorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
❑Addition ❑Alteration DUtility Connection `'
CODE: I.R.C. ❑LB.C. 0 Misc: ;Er1+vMl �&f �Ge\Vto\ v2711'E i Kra pi'tWiRvt
Type of Construction: I II 'HIV V AB qJ 0
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ !n.3 .m
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 aleent 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 •-•.1 for• cause.Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X .// —moi a Q241/2ea6 47/3///x'
''gnature/ Contractor's License No. Date
Permit Valuation - 000 c — Park Support Fee # $
Permit Fee $ • 1 `- S SAC # $
Plan Check Fee $ 1 Sq Water Meter Size 5/8";1"; $
State Surcharge $ Z-Se., 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 Let�6, r„‘...„(4._- $ ( 9 . 7'
This A.it
r1 o. •ecomea our Building Permit When. .. . ed Paid• iu o -7 ' Receipt No. /7 1 ii
)=R i1 1i1,- ?) 4 )4-- Date
1,- Date r s- 1 By �;,,A4 )
This is to certify r, tin the above application and:..,mpanying documents is in acco .,•ce •.the City Zoning Ordinance and may proceed as requested. This document
when signed b a' .r r constitutes a temporary Certificate of Zoning compliance and. •ws co. • etion to commence. Before occupancy,a Certificate of Occupancy must be
issued � '
- 1 4-
NP ..."‘7 .r Date MIN Special Conditions.if any
- .our notice . ll inspection.(952) 7-9850,fax(952)447-4245
. . •_.to: S.E.,Prior Lake,Minnesota 55372
I
F
P R I O R LAKEDEPARTMENT ULDING DOINSPECTION
INSPECTION
ORS„,SITE ADDRESS Ao ifir er
TYPE OF WORK -
USE OF BUILDI‘ _ geei
PERMIT N0. itlDATISSUED s•
BUILDER tl PWi7if - PHONE # sib
NOTE: THIS IS NOT A PERMIT FbR'ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
IFO0flNG I PP I *et � ]
PLACE NO CONCRETE UNTIL ABOVE/� HAS EE IGNED
I FRAMING � oi V I y,Y'� j4
FINAL 97 I 'tr*
FOR ALL INSPECTIONS (952) 447-9850