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Building Permit 14. 1261
2 O O y. § q \ 00 0 / OCOO 0 0 mo % lc n m k x m k>kkkk m A 2 Sio % t qqa ■ r � ■§ � z Jg to - . ■ » = 2 $ -f§» § P o� / co S 0 0 0 \ z Z k X Al § t m r 2 § 2 2 r o mm X o 73 2 0 -c % ■ o R _ m 2 m m i\ 000000 o:\ E ? t �� M� �� .� \ * m 2 m §2§_X§ mm 0 ■ o 0 / 2 rkkk �o 1� m 0 Z m m zXX c / k 0 . r §§ z ] r § m r • § 8 © Q f / U 0 » �DOOODQ ' _ ti / % :1‘ f73mo : �f \ i § � �§$ - 4 00 ... T1x r 2i § § OF PRJiN CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd 0 TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 1/ r . /¢ 7 AND UTILITY CONNECTION PERMIT U t2j 4rIkIVESoIt 1. White File 2. Pink City PERMIT NO./4., ate 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) ' 3y`f1 h? 7-- LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER {,� �- c,� (Name) J I (Phone) (s7 ' 3 7' /2)t (Address) 3 4/T 1 7-41.40 I/420-Nr á'L . )0 Aid 5c3 3 T2 BUILDER Lilt' / (Company Name) Lil d4h4L-j �___ (Phone) (p 1_. - �Z.Z` ^�9'0 (Contact Name) .._...1� E- ®t,ti►� Phone) &II Z Z Z-I )044:9 (Address) rie177/ 3)a s.6' �..j /14,0 i foil U 1 TYPE OF WORK N ew Construction Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑Fireplace '^,edition DAlteration ['Utility Connection 1` CODE: L.R.C. ❑I.B.C. ❑Misc. Type of Construction: I II III IV V A B Occupancy Group: A B E F H I M R SU PROJECT COST/VALUE $ (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-menti• ed property and that all construction will confor to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official c revoke.,is permi•Jus use urt -more,I h e y agree that the city official or a designee may enter upon the property to perform needed inspe tions. / or Signature Contractor's License No. ate Permit Valuation 15)0 — Park Support Fee # $ Permit Fee $ S( SAC # $ Plan Check Fee $ I Water Meter Size 5/8"; 1"; $ State Surcharge $ .(off 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 1 Alk $ �130 This Appli - io ecomes Your Building Permit Wken pproved PaidReceipt No. 'a .i Date r:r":4--. j LIT By t\ C Bin 411 ttieual Date This is to certify that the request in the above application and accompanying d time is is in accordance with the City Zoning Ordinance and may proceed as requested This document when signed by th it lanner cortstitutcs a temporary Certificate of Zoning omp ance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be issued a K co 1 'f _Tanning 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 x- • } ill