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Building Permit 15. 0906
Ui � 1_,■ z / � 1-C1111:: \r /« o c §0U. U. 0 2 k OCOOO IU■ & _ 0 r u 2 w o ■ z - z 2$ J o § z oIT. ..1 Iii I tk- 2277 0 / u t S v co %/�k\� \ - o & a ■ » ena ■ 22 - e 000000 0 0 LU ii x § a a 0 2 Ili > 2 S c \k 0 0 Z ® 3 o U o © o 7 § _0 § - § § $ Q EL - 0 g 2025 z W W 8 8 � � — ■ Q Q o§ us §§ X2 a IC re ce L % $ § § 0 22u.■ 2§ 0 § kk a © § i3 « o a 000000 U o O / o Pio% CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING Date Recd COMPLIANCE AND UTILITY CONNECTION PERMIT . �%HHeso't" 1. white Fir I 'lhN0Jc 1 0� (Please type or print and sign at bottom) yellow Applicant ADDRESS I0 13 kA S ''^ _ S ` , ZONING(office use) LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNERS. nn (Name) r S—I C-� i e4e� (Phone) 219-" )-, —10 13 (Address) gJ7 I 0 Ec'A S CCI ST s (&) BUILDER (Company Name) t 11 , W 1 d'o �S (Contact Name) —1.-leS I (Phone) � �c�'" .1)`11.-01S - (Phone) (Address) ()--°1'}L4'}L4v1 l©1,--kiCl� v1 Qi C4 •1—► f l ())-\ nA j 1"v 1 v S 51—i I if TYPE OF WORK 0 New Construction DDeck DPorch CRe-Roofing ORe-Siding ['Lower Level Finish 0 Fireplace DAddition DAlteration ❑Utility Connection i CODE: ❑I.R.C. DI.B.C. 4isc. \ J 1 h t&0�� k�X� SL Type of Construction: I II III IV V A B WOO Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE S WOO�— 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 a , 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 p .it or just cause. F rt more, agre- a city official or a designee may enter upon the property to perform needed inspections. Contractor's License No. Date Permit Valuation Park Support Fee # Permit Fee $ SAC • Plan Check Fee $ !� ."--1- --- � Water Meter Size 5/8"; 1"; $ State Surcharge $ 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 I • This Application Becomes Your Building Permit When Approved I Paid 73, `M ceipt No. ozf 8„3 Date 0,?-i - I Building Official Date This is to certify that 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 Zoning compliance and allows construction to commence. Before occupancy, a Certificate as requested. This document b issued. p. y,a of Occupancy must be Planning Director Date Special Conditions,if any 24 hour notice for all inspections(952)447-9850 4646 Dakota Street Prior Lake,MN 55372