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04 "/04. CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd0
,, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE , 07
�' AND UTILITY CONNECTION PERMIT
U trj
411NNEsolP I. White File2. PERMIT NO.
Pink Applicant V Vy O�. /1 yt �
3
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
1'161(07 ?riyi,e,
?o1C- CIrcg S ,,jSl0
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION 4.s PIDZ Oil CO 0
OWNER �'0 c r C ti i �� j OST f MLS ?A/c'
(Phone) UDS re."'7 4=ter-';'" V L> SO
G h --TT,
1 MO
(Address) C�9 CO 1 ,_.,,,,,6,..c,„),_.4 --r'�'. W O O U L / /" t w S 5 ) ' -S
Y
BUILDER C� (Phone) "?.0,v- L7 t- `I (,�j -L...(Company Name)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Constr c' n ['Deck ❑Porch ❑Re-Roofing [IRe-Siding ['Lower Level Finish ❑Fireplace
❑Addition Alteration ['Utility Connection
CODE: IYILR.C. ❑I.B.C. ❑Misc.
Type of Construction: I II III IV V A B PROJECT COST/VALUE $ 1 aI O 00_
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 authorized agent for the
above-mentioned proper, 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 thi ,i.-mit for just c •.. Furthermore,I hereby agreeetthatithe city official or a designee may enter upon the property to perform needed inspections.
f1°7.1 - Contractor's License No. Date
Permit Valuation ® , - Park Support Fee # $
00
Permit Fee $ //7.1S- SAC # $
Plan Check Fee $ Z(o 54. Water Meter Size 5/8"; 1"; $
State Surcharge $ Z.50 Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ 5000 Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fe- $ TOTAL DUE ^ $ Zl�6 • gi
This Appli (�o :. /sYurBuildingennitWhenArovd Paid Z.44-6,. 7 J Rec t No. _590b
/ Date //.3,�'C B
id
Bu ding Official Date
This is to certify that t equest in the above application and accompanying documen is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when sig . .y the C,,p Planner constitutesta temporary Certificate of Zoning c plnee and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
2
issued .4;1
40•
A LffrA 1 ii...._ 11 3
Planning Dire . D e Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372
0i p RIo� Date Rec'd
4 e CITY OF PRIOR LAKE PLUMBING PERMIT /o, s.C �J
'INNES.�) 1.Blue File
2.Gold City PERMIT NO. b q 0 67
3.Yellow Applicant I
lease Ai or it and sign at bottom) ZONING(office use)
t ..; ``
1L- G�-7 71 iii ?r„e ,4. C; ce1�
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
?4
4C s 0L1'r; LLC__ r� (s ) -a7O -zi s o
— L VDDo tbb,P-. h ' s ia5
(Address) (City) / ( (Zip Code)
(Contact Pesuo* . ... a. 41. t ' (Phone) `J �7 0 ' 5.`eS Q
CANT. NATURE ,ASP , liD4TE ,.: t o -D7-0 G'
APPLIC,T PLEASE COMPLETE BELOW
Quantity Type of FixtureQuantity Type of Fixture
I Bath Tub with or without shower Awe,' Rough-ins
Dishwasher Water Heater
Floor Drain Water Softener
2 Lavatory(Bathroom Sink) Stand Pipe(Washing Machine)
Laundry Tray(1 or 2 compartment sink Sewage Ejector
1 Shower Stall A 1I a • Backflow Assembly
Sinks Backflow Assembly Test
Bar Sink Lawn Sprinkler
I Water Closet(Toilet) Other
FEE SCHEDULE
Industrial,Commercial&Multi-family 1%of job cost with a$49.50 minimum Residential,New One&Two-Family $149.50
Residential,Additions&Alterations $49.50
Estimated Cost $ Building Permit# pi `01-..,
PLUMBING PERMIT FEE $ n A I 0 OV
r
STATE SURCHARGE $ _ .50
TOTAL PERMIT FEE $ low-
(Office
��
(Office Use Only *k j
This Apt , ' i ��:eco .es�I' wr Building Permit en Approved Paid Recei f o.
/1 3 07 Date By
Buildine 0 ate 4 .
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
DEPARTMENT
PRIOR LAKE BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS /42- ICo7 P/k/cCi C1 te&GE�
TYPE OF WORK //1/2-.
USE OF BUILDING /jCT 4yK-
PERMIT NO. 0 9, D Se 7 DATE ISSUED //•3, 0 9
BUILDER U�Cl-/2/G/ PHONE # GS/ . L7o, o35D
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I ♦�� INSPECTOR �`� DITE
I�II� IPT
PLACE NO CONCRETE UNTIL ABOVE HA§ BEEN $IC�NED
I FRAMING/Pa/BO. Ll-�C U \112 1I7
FlNAL
FOR ALL INSPECTIONS (952) 447-9850