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pie PRI0 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
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a. TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT ��' ti
I. white Fite I PERMIT NO./3, / /yI
2. Pink City �L / � j
(Please type or print and sign at bottom) 3 Yellow Applicant
ADDRESS _
/ 5-.P---7/ W' I L Paday
Ciikay AJ q ( ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER ----' c-,- .,.—
(Name) / k^d��Sc �) (Phone) Q 5 2- J to�
6
(Address)
BUILDER
(Company Name) \
(Phone)
(Contact Name)
(Phone)
(Address)
TYPE OF WORK 0 New Construction ( Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish 0 Fireplace
❑Utility Connection
CODE: LR.C. DI.B.C. 0 Misc.
Type of Construction: I II III IV V A B I
Occupancy Group: A B E F H I M R SU PROJECT COST/VALUE $
Division: 1 2 3 4 5 (excluding land)
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 all constru. on will yy.orm to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official v e this perm r just ',rthermo • ereby agree that the city official or a designee may enter upon the property to perform needed mspec bns.
Si: atu e Contractor's License No, / Date
Permit Valuation Park Support Fee #
3ova $
Permit Fee $
6--z-C SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1";
State Surcharge $ Pressure Reducer
c . �o $
Penalty $ Sewer/Water Connection Fee #
Plumbing Permit Fee $ Water Tower Fee '
Mechanical Permit Fee $ Builder's Deposit
Sewer&Water Permit Fee $ Other
I TOTAL DUE $
Gas Fireplace Permit Fee $ f
This A lie; 'in B%.mes Your Building Permit en A oved I
I Paid / �� If i R eipt No. �'fi7
�%-i_ // J7 �� Date P. /% /3
Building Official --\ Date
This is to certify that the request in the above application and accompanying docum^ is is in ,ccordance with the City Zoning Ordinance and may proceed as requested. This document
when sign'd by the r ity anner constitutes a temporary Certificate of Zoning co ,iance. d allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued. ®
�.ffi. 1/ r , (-3
• Planning rim
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
OF
A ' . LA K� BUILb IN A ND INSPECTION
INSPECTION
SITE ADDRESS /5'2,1 ( (N/L,Q,S P/GYUV
TYPE OF WORK DCGK,
USE OF BUILDING �iS 19/2
PERMIT NO. �.�, )2� DATE ISSUED / /. /9, /3
BUILDER �/�/f,D �/'�$Q� PHONE # S5 s. ¢y69
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
ECfOR
I FOOTING I ��S it �� DATE
PLACE NO CONCRETE UNTIL ABOVE HAS EN SIGNED
4iimiiiii
I I
I FINAL I �� I JZ /4, //
FOR ALL INSPECTIONS (952) 447-9850