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PRio�P CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
c TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 4- / /5
enen AND UTILITY CONNECTION PERMIT
41/vNEsCitt. I. White File
2. Pink City PERMIT NO. /c-- , K�
/_
3 Yellow Applicant /
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
`64A2-7 /i WalifilO da /2.
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER ffc�,F�w
(Name) L�.�'��— �" (Phone)
(Address) 1(D'i Z---t !"cfr4&44.)40 /� Rely...-.d 0� • Re L.,A.,
BUILDER40 ‘ 1c6
(Company Name) '?/''-4- lEf A `--�""'�` (Phone) 6p(. 2-- L1 9 V ^
(Contact Name) a rr (Phone)
(Address) 2-C 7 S ..��t At C,t°ci..' Ted - , (/Lt"'ti
TYPE OF WORK CI New Construction Deck ['Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish I=1 Fireplace
DAddition ❑Alter o ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑Misc. '
Type of Construction: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U
(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( ncr or authorized agent for the
above-mentioned property . hat all construction will c nform to all existing state and local laws and will proceed in accordance with submitted pl.ns. I am aware that the building
official can revoke this.y'or just cause Furthermor , hereby agree that the city official or a designee may enter upon the property to perform nee.•d inspections
X t% �N 7 /c
Signature Contractor's License No. Date
Permit Valuation IC &(,)o 0 Park Support Fee # $ -
Permit Fee $ /05 G 6 SAC # $
Plan Check Fee $ C 9S Water Meter Size 5/8"; 1"; $
State Surcharge $ Z,06 Pressure Reducer $
J
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 I $ TOTAL DUE $ //7/ 75—/ ` 5—
This Applicat• I comesjour Building Permit Wh n Appri ed Paid M/-c15- ec pt No. /0...)
� / • /
Date ¢.<4,.G.S"
Building Official Date
This is to certify that t c re.ucst in the above application and accompanying documen is in a ordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the?ty P a,' er c stitutes a temporary Certificate of Zoning comp' rice an allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued £
iiit . ) `*— /�7 / '----
r Planning Direc. Date Special Conditions,if any
notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372
F
PRIOR LAKE BUILDING D�INSPECTION
INSPECTION
RECORD
SITE ADDRESS N6IZI�t1A16170
TYPE OF WORK 0-) D�C'k-s
USE OF BUILDING /.&
PERMIT NO. /5, 3.3& DATE ISSUED 4. / . /5-
BUILDER PH i f�ur�C�3 Cdfas�c- PHONE # / Z. ,K0.S(41
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I FOOTING �C. apt /
� DATE
NO CONCRETE UNTIL ABO HAS BEEN SIGNED
FRAMING I gA #c"
IFINAL I 7 I 91$1qs---
• FOR ALL INSPECTIONS (952) 447-9850