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of PR7O� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
,, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 2
AND UTILITY CONNECTION PERMIT
*INNES01t* I. White File _
z. Pint city PERMIT NO. �j � sr--
3 Yellow Applicant /V/ �'
(Please type or print and sign at bottom)
ADDRESS c ZONING(office use)
iariiA lAfieY ,
°O
/) die?.e:e Ir.
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
BUILDERif
/
(Company Name 'de lte i ,-c.e i^. �c�, (Phone) /;; "c 3� es ?ir21 T
(Contact Nam :
Name' /;fest .6 > (Phone) o'/....2 .�.-2 -57,1-1-7
(Address) //5 yr n�`aT l r/ ��.4-le 1 /wet _6C3c/(cl
TYPE OF WORK ❑New Construction Deck ['Porch ['Re-Roofing [Me-Siding ['Lower Level Finish ❑Fireplace
['Addition ['Alteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. El Misc.
Type of Construction: 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 tie building
official can ev ke t is ermit fo cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X mak— A5C i✓3 S 76 4 ,—,2 7— Lr—
Signature Contractor's License No. Date
Permit Valuation 31
/� 0 0 00 Park Support Fee # $
Permit Fee $ l•�00V I 15 SAC # $
Plan Check Fee $ 5-1. 3(r Water Meter Size 5/8"; 1"; $
State Surcharge $ I -SI) 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 eiyi 3 I,/S $ I 4'1 . I
This App 0 ti i Becomes Your Building Permit When A,prove Paid /I-Z.7/ Rec t No. 949
./4 3 5 is Date 3 3f.
.-r. „Official a to
This is to certify that th `eque, ' the above application and accompanying documents is in .ccordanc with the City Zoning Ordinance and may proceed as requested. This document
when signed by the C. 'lann,i onstitutes a temporary Certificate of Zoning compliance a d allows'instruction to commence. Before occupancy,a Certificate of Occupancy must be
issued
4 3
31 15
Planning Director Date Special Conditions,if any
r. ' spections(952)4,7-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372
. .
row-P*414ND I porc DEPARTMENT OF
toil ill ler o. ,,, 1... W .. iiiiiill 3UILDING AND INSPECTION
INSPE
TION
°` , rill ,,.,r, r
4ili IL ►
SITE. ADDRESS ® 4,0 A - - 40"
TYPE OF WORK I .� —
USE OF BUILDIN . _ a —
PERMIT NO. • 41 D A E ISSUED • O•f r
INSPECTI'NS _!C 1 to 1 alk*
a r aa.. P...:. .. - . . , -i l SEPARATE DOCI., iLEN 7
INSPECTOR DATE
I FOOTING I b-`-c_ `/ /Z r I ]
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
IFRAMING I ‘. ..->-(_.... 1 Lf (/) ]
I FINAL P/7 y/.s/ ]
FOR ALL INSPECTIONS (952) 447-9850