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o f PRic CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd,
is TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ` } /3'
AND UTILITY CONNECTION PERMIT
Q
4/HNESDAP I. White File
2. Pink City PERMIT NO. l5 6 1
i
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
33 5- Lib(.,0 a .p.,,A,..zi..._
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER n
(Name) link (- ALL-, (Phone)
(Address)
BUILDER
(Company Name) A&9a Tp &)C (Phone) (..v C a—9.
I,qC7-11 C
(Contact Name) "TCS Ai Q._ASA.V17LjA-- (Phone)
(Address) 514w i st, ' t!)-r. 5 L=
TYPE OF WORK ❑New Construction ['Deck ['Porch ['Re-Roofing ❑Re-Si g ❑Lower Level Finish ❑Fireplace
['Addition ['Alteration ['Utility Connection /' d ('2 -/‘'e4 1r �i19J�t�i-a '"
CODE: ! .R.C. ❑I.B.C.
❑Misc. -E-t�� b/4+'�,� Qts'-'c�C`J.��l.c9 .-�.r
Type of'onstruction: I II III IV V A B �� �
PROJECT COST/VALUE $
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 agent 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
off ial ca re oke this p mit for just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
C / ( 1—do—is--
Signature
do—/s--Signature Contractor's License No. Date
Permit Valuation V) 000� Park Support Fee # $
,
Permit Fee $ 301 ftp SAC # $
Plan Check Fee $ ZO i . ( & Water Meter Size 5/8"; 1"; $
State Surcharge $ l K i 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 i "7 Q, 's $ 5 161 1
This App ; ati/ Beco es Your Building Permit Whet Appro ed Paid (j/ Re pt No. lir
'i
' � Date
��l, r 20 / 5 4 z` /c
' Building _ -icial Date
This is to certify tha •r'i,, •st in the above a@plication and accompanying docume is in acco.ance with the City Zoning Ordinance a may proceed as requested. This document
when signed by t / P,g7i t - 's a temporary Certificate of Zoning compl ince and ows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued. —'
4f WV
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
DEPARTMENT
PRI0R LAKE BUILDING ANDOF INSPECTION
INSPEcTION
RECORD
SITE ADDRESS
NATURE OF WORK i2-. 76' rtii &A4a
USE OF BUILDING .4- F..
PERMIT NO. /S—GO DAT ISSUED ‘,2o t S
CONTRACTOR ��6N.10`4.elc PHONE, ..-ct 0 1
INSTALL EROSION CONRTOL AND MAINTAIN CLEANSTREETS AT ALL TIMES
spare ,r s are required
INSPECTOR # y •A •=t
agelligne
Oleetrlette.:-
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING 6P/1 Z?k
INSULATION
ELECTRICAL
Smoke dete torft gt all bts upgrade111111111111116
S mokc dctcen jail be located as per the'Nun er tents of the •
ill all 31cepillg -Ilg stuiy,throughout the hcus.:. Battery o . ed
:eati , e • - -
.:
existing structures.
4111111111111.11111110
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
HOUSEWRAP LATH
FINALS
BUILDING � (
ELECTRICAL
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