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PRIp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(., /d-l
NESo�� I. White File ic
, /J �/z Pinl: city PERMIT NO. �/`/
3 Yellow Applicant /
(Please type or print and sign at bottom) •
ADDRESS ZO G(office use)
5-- -1—\ (SSI- z
-kok u N C-.; SE r-(s1
LEGAL DESCRIPTION(office use only)
5kp . A, l //��
LOT BLOCK) ADDITION fI PID o-Y' 1( -. -
OWNER
(Name) -'7A.''`k '� NMANb A Su.>ENE-,ot 4 (Phone) Co 1 1- ^`(26 6-1-1,S
(Address) 5-S Z\ Le ST kA N\ zs til C i R SE '
BUILDER
(Company Name) RF Le Selrl I N (Phone) Co 1"Z- 4k4 8C(0 k
(Contact Name) 1C3 1 (Phone)
(Address) 55 k'6 C.vS i t'_c)fol CA 0. E
TYPE OF WORK ❑New-Construction ['Deck ❑Porch ❑Re-Roofing ❑Re-Siding ['Lower Level Finish ❑Fireplace
❑Addition Alteration ['Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑Misc.
v
Type of Construction: I II III IV V AB PROJECT COST/VALUE $ 70007`��
Occupancy Group: ABE F HI MR SU (excluding land) /
Division: 1 2 3 4 5
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,[gent 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. ed"is pt for ,.,use Fu ermo);e,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
x ,,' ._..._. P-2-QCC,7—'71 c( 40 t— kii- K--
Signature Contractor's License No. Date
Permit Valuation3/000 , 00 Park Support Fee # $
Permit Fee $ 4.
60.z6
0.z6 SAC # $
Plan Check Fee $ 57. 36) Water Meter Size 5/8"; 1"; $
State Surcharge $ / t,�> V� 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 DUEgot /`. /5 $ /17 ,
This Applicati- o : :. . _ •ermit When Approv d Paid /'47• It ( Receipt No. �U C)
� Date f . 0-0 • t C By e
.uild ng Of 7cia Da e
This is to certify that the request in the above applicatio = -.mpanying 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 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 Prior Lake,MN 55372
PRIOR LAK , DEPARTMENT OF
IG BUILDING AND INSPECTION
IN PE TI N E D
SITE ADDRESS 551/ G-orte Dd eAR- .
NATURE OF WORK /jc/ - o r 71iOO --
USE OF BUILDING r / A--
PERMIT NO. 15- 44- DATE ISSUED /. /4. . I 5
CONTRACTOR /Z , L.-SC& PHONE (0/2.- 9--il-. 6gO/
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECTOR DATE
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PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
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FRAMING .ry � 2 t t S---
INSULATION
ELECTRICAL
41111111111111111111111 ____
HEATING (/f/ v'b)
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COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
EgiNINIIM mer
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BUILDING 0 I/ 1/0. i,( —
ELECTRICAL
HEATING ( /,G/e U`13
isammis
O 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