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Building Permit 15. 1044
n 5 0 O O■1s 0000 10 v �/ O - oma 2 �o s ■ ■� % � m n� n n 0 0 0 � k� � �� » . mm g § z ° m m 2 0 � §■ Cn m AW / / 6 g' c co /• C\ P a 2 v„,„7 0 r § - 11 -a13 000000 7J JD A M x 0 0 E;20 * z c co mm m x& mm§_ m E 0 ■ o o --§7M3z Z k 2 \ $ . I o o © M - § ■ m �' � r � oo ■ \ 0 % r k m 0 z k r / 0 k 0 0 ooOOOQ § Q _ _ m m 0 tq >° / § > ¢.„ r 0 -4 _@ Et21 § m i Rec'd re♦( O* CITY OF PRIOR LAKE BUILDING PERMIT, i� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 9pate AND UTILITY CONNECTION PERMIT U 1= I. White File PERMIT NO. `Jr /0 t" 2. Pink City y�NpggOt 3 Yellow Applicant Please .e or ,riot and si_ at bottom) ADDRESS ZONING(office use) é/t /66 E1ou<,�AaM C' (V ir LEGAL DESCRIPTION(office use only) PID LOT BLOCK ADDITION U pq OWNER / # ' (Phone) C l� —`- �� (�L (Name) f' Z (Address) / ,-. , -iAJ BUILDER /� (Phone) Gil s-7—2- Nl j (Company Name) % Z (Phone) (Contact Name) _ 4-4.4 - - i , (Address) 11"1-6" ��� s TYPE OF WORK O New Construction ['Deck ['Porchite-Roofing ORe-Siding ['Lower Level Finish O Fireplace ['Addition ['Alteration ['Utility Con ectton ❑Misc. CODE: DLR.C. DLB.C. QpQ Type of Construction: I II III IV V A B PROJECT COST/VALUE $ `4 • Occupancy Group: A B E F H I M R S U (excluding land) Division: 1 2 3 4 5 hat I the uthorized agent r the I hereby certify dthat I have and that mconstruction will conform to all xtis to theisting state and loest of cal laws and will proceed y knowledge true and coma. acco dance withtsubmitted plans.owner I almsaware that the building above-mentioned property and �_� . official can revoke this per...t for j cause. Furthermore,I hereby agree that the city official or a designee may enter upon theropetty to perform needed inspections. X /�� Ill S✓ Date Contractor's License No. Signature Park Support Fee # $ Permit Valuation Permit Fee $ SAC # $ $ Water Meter Size 5/8"; 1"; Plan Check Fee UIIIMINIIIII $ Pressure Reducer 11111.1.1111111 State Surcharge $ Sewer/Water Connection Fee # 111111111111111 Penalty $ Plumbing Permit Fee $ Water Tower Fee # $ Builder's Deposit 111101111111111 Mechanical Permit Fee Other Sewer&Water Permit Fee $ ;� Gas Fireplace Permit Fee $ TOTAL DUE umum s! � This Application Becomes Your Building Permit When Approved Paid [Wei it No. Date IWJLESIIIIIIIIIIVPAIIIIIIIIIIIIIIIIIII B uildine 01'ticial Date 41 thc may eed as nt This is tosigned certify that the request lnnertcostitutes a temporary Certificate of Zoning anying ocompliance ands is in allows construction tto commence. Before and a Certificate requested. Occt OccupancyThis mustmust be when signed by the City Planner issued. ------ Planning Director Date Special Conditions,if any 24 hour notice for all inspections(952)447-9850 4646 Dakota Street Prior Lake,MN 55372