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-Ll'eplc,, CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 1 /p,iS�
AND UTILITY CONNECTION PERMIT
121
J 7 i.White Fite /s' 7/j 7
"y'NHteso'tr z pini: City PERMIT NO. / /V� r/
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID 2,5.4 (0 .0 O8 m 0
OWNER
(Name) V.-C°0 ` (Phone)
(Address) q LI
J p p�
BUILDER ,, , C al ' -, (Phone) t 2""' LI"I 7 ,2,7g K
(Company Name) ������t,�n►�{.� �
(Contact Name) - ,ntc f Lia.;'_y,' •e►1. . (Phone) (0't Z.,— .34,Ci '- c3 13
(Address) f:31 W i 0 "I7 CST. 45 V ✓ ai4 37,3
TYPE OF WORK 0 New Construction tQJeck ❑Porch ORe-Roofing ORe-Siding ❑Lower Level Finish 0 Fireplace
❑Addition ❑Alteration ❑Utility Connection
CODE: ❑Misc.I.R.C. ❑I.B.C. -- _._. __
Type of Construction: I II III N V A BPROJECT COST/VALUE $ 241,I, OM
Occupancy Group: ABE F HI M R S U (excluding land)
Division: 1 2 3 4 5 t
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 1 am the owner or authonzcd agent for the
above-mentioned property 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 this permit for Just ca e. Furthermo ,1 hereby agree that t r city official or a designee may enter upon the property to perform needed inspections.
XDa
Signa - Contractor's License No.
Permit Valuation . Park Support Fee # $
Permit Fee $ l p f-1 .2-C SAC
Plan Check Fee $ q 4-1 ( j Water Meter Size 5/8"; I"; $
State Surcharge $ l , { 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 $ 3 TOTAL DUE $ '7__4 • 4G,
This Appii o ecomes Your BIlding Permit en A oved Paid 2.#6., Recei mt o. 5z_
Date 7. y7. / I B ji i /'
Eluil m_ fticiai , Date
This is to certify t the ,rest in the above application and accompanying doer nts is in ordance with the City Zoning Ordinance and may proceed as requested This document
when signed by ti ity ',nner constitutes a temporary Certificate of Zoning co Lance allows construction to commence. Before occupancy,a Certificate of Occupancy must be
slued_ �_
`1 t ? r3 r.
annin. 0-rector 0 to Special Conditions,if any
24 hour notice for all inspections(952)447-7851)
4646 Dakota Street Prior Lake,MN 55372
•
DEPART
ENT OF
P R I O R LAKE AND BUILDING G NSP C'TIONSNG
INSPECTION
RECORD
SITE ADDRESS 3342 M/rtey7 er
TYPE OF WORK DEe14
USE OF BUILDINGe�.
PERMIT NO. iS. 79� ��IED 1. /O. 15
BUILDER MA//Qw//tzip BU/WE,iK.S PHONE # 44-7, 2796
INSPECTOR DATE
I FOOTING I 0`ti-- � £sl 1cS' r
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIG`NED
( FRAMING I I s-
I
I FINAL I I
� y� ty I is
FOR ALL INSPECTIONS (952) 447-9850