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o`� l'RIOCITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
tiANTEMPORARY CERTIFICATE OF ZONING COMPLIANCE if) `
AND UTILITY CONNECTION PERMIT `' '/
"NEs0
t.White File
2. Pink City /±2 1 PERMIT NO. ..,.l(/
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
387-3 C a brier\ CT 3\V, R,-0( Lke �Us�
LEGAL DESCRIPTION(office use only)
LOT 2-BLOCK 2. ADDITION lJ/��411"9-1 t ` 'I :\S PID 45-- I/f71'O10®"0
(Name)OWNER MD
�"h D UCa.r1+" (Phone) 9 Sol-os to - /02 y,>
(Address) ,?j 73 O b( ;e n G'T
BUILDER NIA 9-1
(Company Name) N (Phone)
(Contact Name) 50..M e CAS abou C (Phone)
(Address)
TYPE OF WORK 0 New Construction peck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection
CODE: DI.R.C. DI.B.C. 0 Misc:
Type of Construction: I II IIIIV V AB Q
Occupancy Group: A B E F 2H I M 3 4 S S U PROJECT(exci COST/VALUE� $ 8,000
Division:
nd)
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 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 •. this permit for j Aiiicause. F ,.••ore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X . %natare Contractor's License No. Date
Permit ValuationPark Support Fee # $
`looO # $
Permit Fee $ l Z .•so SAC
Plan Check Fee $ 8G . 13 Water Meter Size 5/8";1"; $
State Surcharge $ Pressure Reducer $
3 •c7o
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Ark
Gas Fireplace Permit Fee $ TOTAL DUE $ '� 1 . 3
�o t t 1 i ,,1 - f?�� t�
. . .."41....,,, .
Your Building Permit When Approved r :'1 , �? a 1j Receipt No. r `
�te /2 ( By .,—'A4 -
Buildi/O"• D AI
documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
This is tog certifydbthat the Plannerarmins the above temporaryon and accompanyingefZ occupancy,a Certificate of Occupancy must be
when signed by the City constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before
issued.
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
F
PRIOR LAKEDEPARTMENT ULDNG A DINSPECTION
INSPECTION
SITE ADDRESS egalkOX�� efr-
TYPE OF WORK 17&
—
USE OF BUIL.DIN . t
PERMIT NO. / +�P DATE ISSUED P • ��‘
BUILDER APP-117;77 PHONE # • #61.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTORE
I FOOTING --- 1� � �� � Co ��3
PLACE NO CONCRETE UNTIL ABOVE HAS BEE SIGNED
11111
IFINAL
FOR ALL INSPECTIONS (952) 447-9850