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Building Permit 15-0040
5 O 4 n o o000 ° o › E0 w 0 0 K c ® §� 00 2 m § 2 / ).c k r m omrn F ■ r > § kz z k � � q a 2 1) �o� Q P 273 2 ■ » 2 rn z - z 0 C B 9 730 \ S 7 § q �� § 0 k o 0 © . Mm ■ 0 P c.i4. mil 73 0 o 000000 41 X q MM s -a ® ■ sem i ki §° REPINE '' $ 2 K f m 11 § ■ § 73 § m 0 0 § E m � -4 > 000 o § m 12 \ 2 r � §§ ! § z n m r m m p m / ■ § z m § 0 . m 000000 Li / 7? iii § g ‘ § R. Q ca \ 10 m a § § � 0m rn 71% - ,, ■ r 2 CO; 0m 1 1 of PRic3 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd ,, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE i AND UTILITY CONNECTION PERMIT it � ` 6 U �j • 4NrNggp11' I. Pinkke ie PERMIT NO. 3 llCity t6', 3 Yellow Applicant � (Please type or print and sign at bottom) ADDRESS C tiql (A/ ACI AI \ `k"'C,'' j s' 37 ZONING(office use) LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID WNEf (Name) R v Do'y/ (4a �$ (Phone) (Address) SGI,yn(1_ A) 4evt BUILDER Company 'e 1 ice: f 1°S ' CI* Phone A3 :370111(C - "ompany Name) ♦ ( ) • (Contact Name) _ . 'n+• (Phone) 1G 2 (Address) eCtd CVS" h ? i `C l,- _ ��Sap TYPE OF WORK 0 New Construction ['Deck ❑PorchRoofing ❑Re-Siding ['Lower Level Finish ❑Fireplace ['Addition ❑Alteration ❑Utility Connection CODE: ❑I.R.C. ❑I.B.C. ❑Misc. `moo Type of Construction: I II III IV V A B PROJECT COST/VALUE $ /f L/ �C, Occupancy Group: ABE F HI MR SU (excluding land) Division: 1 2 3 4 5 I hereby certify that I have furnished information on th,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 i operty and that all co- auction wi conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official can revok !his permit for I st can• urtherm'- e,I hereby agree that the city official or a designee may enter upon the property to perform needed nspecti ms. X � CC__,C,9-71(1-7 I MOW"OF / Signature Contractor's License No. Date Permit Valuation Park Support Fee # $ Permit Fee $ '7 q, 7 SAC # $ Plan Check Fee $ Water Meter Size 5/8"; 1"; $ State Surcharge $ L)t._ 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 $ --19 , This Application Becomes Your Building Permit When Approved Paid 7q., 75' Receipt No. �c, Date I. /4, ( T By C51it4-1-•) Building Official Date This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and 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 Occupy ncy 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 Prior Lake,MN 55372