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Building Permit 13. 1132
5 0 C Y61. n O' c000 . 0 a ■ n PO n n § § § . 0 Y2K@kk z �� r s rrz = ■ ■ � 2 m m m § � Eo ■ ■ -m■ cn §® qQ P z- to ■_�- ■ cn o z 0 z ... § ��7 2 0 z kk n m t g F z 2 F 0 3 I -n "om 2 0 § 000000 § - m � E •ocn ■ E � zo o nc � 0c z § ■ § i_ § m o n 1 .1E ? 2cn ; \ zzszz 3 z § C / 0 r , OO — 2 c r r � � § \ 2 Xm o kOOOOco — o © § 22 § � - � § EN § E ... \ 53 z > � I mem■ " - ter / � i § of PRtofi CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE [..4t ;, ii, 7., AND UTILITY CONNECTION PERMIT ....._ tP 2,p„ite '` PERMIT No. /q/oJ 3 Yellow Applicant • i t (Please type or print and sign at bottom) ADDRESS ZONING(office use) 17662 Natures Way SE R./ LEGAL DESCRIPTION(office use only) LOT 3 BLOCK 5 ADDITION ME ENCl.,1 V6 4 et-6- ''y mww. 'ID 25 4.5.f. 048. Q OWNER Brian Schwartz (Name) (Phone) (Address) 17662 Natures Way SE BUILDER (Company Name)Owner (Phone) (Contact Name) (Phone) (Address) ' TYPE OF WORK ❑New Construction LODeck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish 0 Fireplace ❑Addition ❑Alteration DUtility Connection h, C o;► %I.R.C. L711.B.C. 1=1Mise. Ty i. t•Av.• .. on: I II III IV V A B PROJECT COST/VALUE $ 6,000 Occur`"""..roup: A BE F III MR SU Division: 1 2 3 4 5 (excluding land) I hereby certify that I have fiimished information on this application which is to the best of my knowledge true and correct. I also certify that lam 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. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. x :- -4 1 0/1 0/1 3 • • - • Signature Contractor's License No. Date Permit Valuation 4"/ 000 . O 0 Park Support Fee # $ Permit Fee $ /U 3. 0 o SAC # $ Plan Check Fee $ G G IC Water Meter Size 5/8";1"; $ State Surcharge $ 2 . 00 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 efrig $ [ n d This Application;>e I,0 s Your Burbling Permit Wit A roved Paid lin,"7 6- Receipt No. 7b/'� l'i ID ro Date /0 ////2 BY Gw(�4 Building Ol icia Dat This is to certify that the request in the above application and accompanying documents .in ace idance with the City Zoning Ordinance and may proceed as requested. This document when signed by the ity Pt n er constitutes a temporary Certificate of Zoning complia i e and lows construction to commence. Before occupancy,a Certificate of Occupancy must be issued. /4 .�_ rG r® ( r: ning Director Date Special Conditions,if any 4 hot notice for all inspections(952)447-9850,fax(952)447-4245 - -.,•Dakota Street Prior Lake,MN 55372 S DEPARTMENT OF BUILDING AND INSPECTION ,. SITE ADDRESS ../7 & /� l / '` `, d/A — TYPE OF WORK _ USE OF BUILDING £ r1//L _ PERMIT NO. /3 /1 DATE ISSUED /D. !a- l3 BUILDER i ofe, PHONE # eila. 9. i 3 NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW THE PERMIT IS BY SEPARATE DOCUMENT IN P. = OR DATE I FOOTING ..v.7.4-4I / � X �"' /0,/15 PLACE NO CONCRETE UNTIL • E HAS BEEN SI NED ( FINAL I f 3 � y FOR ALL INSPECTIONS (952) 447-9850