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o4 PRtp+P CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
s
; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 7 I - 13 r 1v"�
tv AND UTILITY CONNECTION PERMIT
~'HNesooh I.2 P nWhtke File
PERMIT NO.
--6-;-----7 .
/3
Yellow Applicant l s
' • pe i . t and sign at bottom)
ADDRESSZONING(office use)
�
/54:74- O00 DOC,,.. i7 ,
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
Jfiv) ]O iheLt3 / 2Jli 4►od=Re.{il (Phone) (1_62' 006 t J13
(4
(Address)
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction ❑Deck ❑Porch ORe-Roofing ORe-Siding ower Level Finish 0 Fireplace
❑Addition ❑Alteration ❑Utility Connection
CODE: ❑I.R.C. DLB.C. 0 Misc.
Type of Construction: I II III IV V A B PROJECT COST/VALUE $
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 true and correct. I also certify that I am the owner or authorised agent for the
above-mentioned property and that all construction ill 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 i or‘,I hereby agree that the city official or a designee may enter upon the property to perform needed inspect ms
X i C t :j13 __
ignatur i� Contractor's License No. _ Date
4,
Permit Valuation ( 0 Q 0 .c) 0 Park Support Fee # $
Permit Fee $ & a?j SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ / o c"c Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ 5-4,, f .) Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee I $ _.------- TOTAL DUE $ // 7• _
This Applic, i i :ecomes Your Building Permit When Approved Paid // l- 7„7.7C—
Date
„ Rec t No. (� `, ; a
I Date /. /...›� By
.• g Official Date
This is to certi' 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
RO
PRIOR LAKE BUILDEPADINGTMENT AND INF
SPECTION
INSPECTION RECOR '
SITE ADDRESS /5d141IV.00 ote ,
NATURE OF WORK /661,617.0"
USE OF BUILD!
PERMIT NO. DATE ISSUED . I.
CONTRACTOR nAharAEWS. PHONE 110
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECTOR DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
Argasommiffintamic
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING
eadialablefiJEMSMIVEIONIV6MT
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
LATH
FINALS
BUILDING
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