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(6 .A./. CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / - I,i 5(3
AND UTILITY CONNECTION PERMIT
1.white Fite
a. rink city PERMIT NO. /7. ,7 -4
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
5118 7ieAtix bye 1i) fr.Tog Li9ge ,4W 137z
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER d �,,,.,p
(Name) fl�4-"4 Lc J 00-41'6/� (Phone) 507 ex--. 107
/b- '
(Address) 3378 4, a SG,, /z06e M,, / A' o
BUILDER
(Company Name) .5fZ (Phone) AY/T.
(Contact Name) 5Eir (Phone) AO
(Address) 10
TYPE OF WORK 0 New ConstructionDeck OPorch ORe-Roofing ORe-Siding ['Lower Level Finish 0 Fireplace
❑Addition DAlteratzo 0 Utility Connection
CODE: DLR.C. DLB.C. 0 Misc:
Type of Construction: I II III IV V AB X00
Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $ /
Division: 1 2 3 4 5 (excluding land)
Thereby 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 can revoke this 't for ju ause. Fthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed' ons.
X ' . _— ... .7 igh-1
Contractor's License No. Date
Permit Valuation '(�Q. Park Support Fee # $
Permit Fee $ //I'll—
SAC # $
Plan Check Fee $ -7&. 6-*
!- 6-* Water Meter Size 5/8"; 1"; $
State Surcharge $ Z. 5-4, 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 - $ /Gi►/ 1
( [(O
This App;' i4114' wises Your ding Permit ' en Ap9(0.ved Paid /� . ? I R eipt No. Cp 45-�
11 ri
# (.3 Date 7, /C,/2 )
Buil `n.i r Date
This is to certify tha 'e in the above application and accompanying docu ...is is• ordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by ' zy :-, er constitutes a temporary Certificate of Zoning....'lance d allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued.
Planning Directo` ate Special Conditions,if any
i r notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
DEPA
TMENT
F
PRIOR LAKE BUILDINGINSPECTIONDOINSPECTION
INSPECTION
RECORD
SITE ADDRESS 309s 71he.✓✓�Z-- aZ-
TYPE OF WORK e-e-16-
USE OF BUILDING
PERMIT NO. /3 . 7�1--- DATE ISSUED 1• iS./3
BUILDER WENN/N�� PHONE # 507. Z?6. 5D 0 -7
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING W G "7/15I ('e
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I 14)-
IFINALIMINMEMI
I I J
FOR ALL INSPECTIONS (952) 447-9850