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of PRIn CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
KNESOD)
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE - , 3
AND UTILITY CONNECTION PERMIT I. White File
2 Pink City 1 PERMIT NO. 13.._ q
3 Yellow Applicant r `\
(Please type or print and sign at bottom)
4.0
ADDRESS ZONING(office use)
Li-261 5/-fiq,o 0 'E*c M Y1 N. G�1.
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER /y..„
(Name) .) r 5 5G If I L5 L (Phone) [,1 --,3-75O' " '
(Address) i i +275H-4 0') (j e*C H-i --i— (, Aa V a
BUILDER
(Company Name) / 111-6 PI 121E IO K 104--7J on)5)r
(Phone) 12—` 0---7L f�j
(Contact Name) CO (/ `J (Phone)
(Address) 1 I vl 2 10 U C001/000 `7g, LJ �p-A))v / /v 'S•i 23
TYPE OF WORK 0 New Construction ❑Deck ❑Porch DRe-Roofing [Me-Siding ❑Lower Level Finish 0 Fire lice
,Addition DAlteration ❑Utility Connection
CODE: DLR.C. DL � LL) nt� 4
B.C. Misc. — t Ds t) S
Type of Construction: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: ABE F III MR SU
Division: 1 2 3 4 5 (excluding land)
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 c. revok this pe ii; just ca Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
I X ; ./.. 5C 66 r 60 F 1',3
ISignature Contractor's License No. Date
Permit Valuation Co O Park Support Fee # $
Permit Fee $ 'I 19 SAC # $
Plan Check Fee $ 10•c Sr Water Meter Size 5/8"; 1"; $
State Surcharge $ Z S,, 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 a s9.1 t . 3 t �t3 $ I q "
li��w / l �-
This App'ation . co es Your Building Permit Whe, Ap, t ved pa � n , f19 Re ipt No. tog �''��'
I A .
/ 3 e.2 /.3 Date 1l i 3
G I
Building Official tate
b 61 7,I '
This is to certify that the request in the above application and accompanying 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.
3-e-/3
PI g 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
P RRLAKEDEPARTMENT OF
UIQI B
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS ��Z�� ` b.5 --
1 -P.NATURE OF WORK
AcoD(T (c)J‘i + P>i)LTwkc
USE OF BUILDING F-6-3 , t- tz_.
PERMIT NO. ( 1 - 16A \ DATE ISSUED .3 4,4(i 3
CONTRACTOR (PS Pt R,50 v,,4-t..ce s PHONE (z -5r o •7 45--/
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
•iFC)97g1461)
I I
JFOtINfiAflON (prjor.to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE
HAS BEEN SIGNED
ROUGH - INS
FRAMING
ELECTRICAL
H rOcif required)
Ett
G _ EST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
ti-e\-i-e-(4,YAri 0 '84 Lt-3- 43 -1
FINAL
,43T(Mayr to Sodding)
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