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o PRj0R CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
411yHEso'ih I. White Fite
2Pink City PERMIT NO. /3,0 M.
.
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
2'+-►I CO U tr P6*h MAA Ths.23
LEGAL DESCRIPTION(office use only)
LOT ( BLOCKc:2. ADDITION � '—`'�S f J/Z,�` % PID 4l- -
OWNER �J (�
(Name) 1` 4 �Z��a e. 1& l (Phone) "I 62_ 01'4 1-1!0 I
(Address) 2-`7" i c Cn 9a.le-- Pa- NW pvi O Lt, k.e , M Int 3 72_
BUILDER /
(Company Name) /4'71 (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction ❑Deck ['Porch ORe-Roofing ❑Re-Siding ower Level Finish 0 Fireplace
❑Addition ['Alteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. 0 Misc. X4r U
Type of Construction: I II HI IV V A B PROJECT COST/VALUE $ ►®00 . 00
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 nue 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\Furth a re,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X _TZ2V/V , V ,
Signature Contractor's License No. Date
Permit Valuation .2 Q coPCZ) Park Support Fee # $
Permit Fee $ '744.. 7s SAC # $
Plan Check Fee $ _ Water Meter Size 5/8"; 1"; $
State Surcharge $ / St) Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ L� Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ /337, 7..
This Application Becomes Your Building Permit When Approved Paid /30, 73 R ipt No. —F t
Date c/S' e-
Building Official Date
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.
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
RNO
PRIOR LAKE BUILDEPADINGTMEA NDT INF
SPECTION
INSPECTION RECORD
SITE ADDRESS 23 C-J61c141(-- P
NATURE OF WORK G 2w X-
USE OF BUILDING p
PERMIT NO. 13. 4-24, DATE ISSUED S,/S
CONTRACTOR WPHONE 9,k 3, 4-0/6
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECTOR DATE
MEM
11111.11111111111111111111.1111111,
1111111.11.11111111111111
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
1111111.111111111....1
FRAMING
//,
INSULATION /,h 7,
ELECTRICAL i�
PLUMBING s i'u tef 7;67
HEATING ti'l J' J /
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
41111111MMI LATH
FINALS
BUILDING 9I
ELECTRICAL
II
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