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Z a Y oc OO O O uuuV U U E z < 0 a ❑ ❑�❑ ❑ 0 \QJ❑ 0 c r of PR��+P CITY OF PRIOR LAKE NG PERMITDate Rec'd t. TEMPORARY CERTIFICATE OFBUILDIZONING COMPLIANCE a (2 l� AND UTILITY CONNECTION PERMIT Z.1 m I. White File /•lJ r /ci e 6 y�ivNEsdij z rink cit PERMIT NO. G f- v 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING( ffice use) `i 760 LarCi S'S-r e.-1/4- 10 . PS 9 LEGAL DESCRIPTION(office use only) (j LOT BLOCK ADDITION PID ,lr. (13 . al 0 , OWNER . �j�d� �IS— �'3; (Name) S3-0C 1'�J'C USc-C' (Phone) J''o 3 Li (Address) l:fq Lc rats 5-111- it N E, BUILDER (Company Name) Joe. f(U 5 e.-.r (Phone) (Contact Name) (Phone) . (Address) TYPE OF WORK ❑New Constr>c ion ODeck ❑Porch ❑Re-Roofing DRe-Siding ['Lower Level Finish ❑Fireplace ['Addition Alteration DUtility Connection CODE: ❑I.R.C. ❑I.B.C. ❑Misc. Type of Construction: I II III IV V A B PROJECT COST/VALUE $ aC) 000Occupancy Group: A B E F HI MR SU (excluding land) Division: 1 2 3 4 5 l 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 official can revoke this permit for just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. 1 X pt-c_ lou_AA.0...,___ /0/4, y Signature Contractor's License No. D to Permit Valuation `t9r 404 / Park Support Fee # $ N. Permit Fee $ 4. SAC # $ Plan Check Fee $ 16. Water Meter Size 5/8"; 1"; $ State Surcharge $ ''— / Pressure Reducer $ Penalty $ Sewer/Water Connection Fee # $ Plumbing Permit Fee $ 5-1-1, © Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer&Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL DUE U40 dt.a,14,- $ 15 . r.t , r;� s--� -�� Ir � This Appl 'io' 'ecomi.Yl ur Building Permit When •pprov i Paid , '15.`TS Receipt No. L CY 1, Date to2 . 11 ByAi uII. �� .dingr.fticia D to This is to certify that the request in the above application and accompanying documents is i accordance with the City Zoning Ordinance and may proceed as requested. 'this document when Signe the f ty Planner cotkstitutes a temporary Certificate of Zoning co .liance nd allows construction to commence. Before occupancy,a Certificate of Occupancy must be issued. • .in :Mr- • 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 G Date Recd CITY OF PRIOR LAKE PLUMBING PERMIT - al°`d Sty Cit PERMIT NO. z oot 3.Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING tome,:use) If -M U L cA5 s; N E (Jct oc Lo:L Cv .553-n- LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER i� (Name) :TOb J�-�t�l}j�_( (Phone) !q 6;?-- ` '3 (Address) fyle APPLICANT q (Name) oo r- (-r c-u i(-P (Phone) / -e 15—�3 ,39y — (Address) -1 (.JadS j) Me- erIOl Late., o'V1 f0 5-537.41L (Address) (City) (Zip Code) (Contact Person) (Phone) APPLICANT SIGNATURE ZI�D�/� DATE APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher Water Heater Floor Drain Water Softener Lavatory(Bathroom Sink) Stand Pipe(Washing Machine) Laundry Tray(1 or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly Sinks Backflow Assembly Test X Bar Sink Lawn Sprinkler Water Closet(Toilet) Other The Minnesota Statutes FEE SCHEDULE §326B.14g [Miami cost with a$49.50 minimum Residential,New One&TwoFamily $149.50 "SURCHARGE"has been extended Residential,Additions&Alterations $49.50 The minimum surcharge fol.a "fixed fee"permit is$5.00 $ Building Permit# -PLUMBING PERMIT FEE $ STATE SURCHARGE $ XVI 5.00 TOTAL PERMIT FEE $ (Office Use Only) This Application Becomes Your Building Permit When Approved Paid Receipt No. Date By Building Official Date - f 24 hour notice for all inspections(952)447.9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 PRIOR LAKE DEPARTMENT F BUILDING AND OINSPECTION INSPECTION RECORD SITE ADDRESS 4*i • o : •SINZer NATURE OF WORK • 1,1"' �r" �" ' w USE OF BUILDIN .4;1770' PERMIT NO. I DATE ISSUED [411r . CONTRACTOR (I, ' 7 a PHONE *Si . Z;/ .13 INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES INSPECTOR DATE :411=1"ggiat PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS FRAMING E J- '/) #5- INSULATION ELECTRICAL PLUMBINGf% /1S 1K HEATING v' COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED APawn. FINALS BUILDING "IP -*/0? _ ELECTRICAL PLUMBING HEATING 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