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�� PRi°.p CITY OF PRIOR LAKE BUILDING PERMIT,
A.
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Date Recd
AND UTILITY CONNECTION PERMIT
I. White File
(Please .e or .rint and si_ 2Pink citr PERMIT NO.
at bottom) 3 Yellow Applicant `s
ADDRESS
J
�7
7y. ki. ,A( :33-32 ZONING(office use)
.).- r
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION
OWNER PID
(Name) i
(Address)
�‘J'' .7 e..0 r-r-s) -4 / ,,/ (Phone) 4#1 �U — �(�
BUILDER g- #4, �~ •i
(Company Name)
(Contact Name) (Phone)
(Address) (Phone)
TYPE OF WORK 0 New Construction
❑Deck ❑porch
❑Addition ❑Re-Roofing
❑Alteration ❑utility Connection g ORe-Siding • !I ower Level Finish
0 Fireplace
CODE: ❑I.R.C. ❑I.B.C. r
Type of Construction: 0 Misc.—
Occupancy Group: A B I II III IV V A B
Division: E F H I M R S U PROJECT COST/VALUE $
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 orI
above-mentio. • property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am
,' I official c. revok this per it for just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the
9 authorized agent for the
X j aware that the building
-��_' P property to perform needed inspections.
�, Signature +,
Contractor's License No. ar'
Per/rt Valuationaniummmoriw_milINEEMaill
Da
Permit Fee Park Support Fee
# 11111111M1111
Plan Check Fee IIMMINFAMIII. SAC #
IIIIIIIIIIII
Ilingillaillimum Water Meter Size 5/8"; 1
gIIIIIIIIIIIII
Penalty
Pressure Reducer
1111111111111111
Plumbing Permit Fee Sewer/Water Connection Fee #
111111111111111
■ Water Tower Fee #
gIIIMIIIIIIII
Mechanical Permit FeeMMMIIIIIIIIIIIIIIII
gIIIIIIIIIIIII
Sewer&Water Permit Fee Builder's Deposit
111111111111111
Gas Fireplace Permit Fee Other
UIIIIIIIIIIIIII
TOTAL DUE^
This Application j 4 omes Your Building Permit When A
\IApproved Paid III
. G IA( ( - . IltirMINVAIIIIIMMEml
Date ZQi.t No.
Buildin •fticial
Date
.4 This is to certify th< the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may
when signed by the City Planner constitutes a temporary Certificate of Zoningcompliance and allows construction to commence. Before occupancy,
issued p
proceed asf requested. This document
P� y,a Certificate of Occupancy must be
Planning Director
Date
24 hour notice for all inspections(952)447-9850,fax(952)447-4245 Special Conditions,if any
4646 Dakota Street Prior Lake,MN 55372
RMENO
PRIOR LAKE BUILDINGDEPATANDT INF
SPECTION
INSPECTION RECORD
SITE ADDRESS 36/7
NATURE OF WORK �:
USE OF BUILDING •
+'
PERMIT NO. � � �'
CONTRACTOR 1-17,-/ -"� DATE ISSUED .2- �
INSTALL EROSION CONRTOL AND /0---MAINTAIN CLEAN SOTREETS
AT ALL TIMES
INSPECTOR
DATE
PLACE NO CONCRETE UNTIL ABOVE HAS B
ROUGH - INSr3- 11.0101numminsimin
BEEN SIGNED
FRAMING
INSULATION e4 ®�
ELECTRICAL
lit......_■•=111111111111............._11111111111111111111111111
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
FINALS
BUILDING _ - -
ELECTRICAL ,_'®�
HEATING t' / ^?,2U`,
DO NOT OCCUPY UNTIL ABOVE HAS /'
BEEN SIGNED
This card must be posted near an electrical
NOTICE
service cabinet
maintained until all inspections nhel a been approved. prior buildingstrough-in tions where
and
service cabinet is available, card shall be placed nearn main and entrance. where no
entrance.
FOR ALL INSPECTIONS (952) 447-9850