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0F PRio- CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
t• TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
,1. x AND UTILITY CONNECTION PERMIT /0, 30. 1
v fti
"NrivESO.�� I. white File2. PERMIT NOPink City .y /i._
/ 7
3
3 Yellow Applicant eee.....���
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
7 W
1 (o j?JFvN%a, iA E A.A..,., N't,.) I ? (alt, ( , ' ' 5-5391 t�t S LJ
LEGAL DESCRIPTIONJ (office use only) /' /n
LOT BLOCK L2 ADDITION ���� j �y � PID aS '4 /7 Div' V
OWNER A s-irE' (Phone) 9t 5Z —"So —38 12—
(Name)
(Address) i 74/G 73Ex.,--aP'v- A ' "...E Ali--) ,FPS t4A.- 1_,A tc4, M.n/ S.' 3"79
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑New Construction ['Deck ❑Porch ❑Re-Roofing ❑Re-Siding (.ower Level Finish CI Fireplace
['Addition ❑Alteration ❑Utility Connection v
CODE: ❑I.R.C. ❑I.B.C. ❑Misc.
Type of Construction: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: ABE F HI MR SU (excluding land)
Division: 1 2 3 4 5 i
I hereby certify that I have furnished inft- tion 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-me ti ed pro and that co •ruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
(Aliciaoke t permit for t cat: . Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed i spcctio .
Signature Contractor's License No. ate
Permit Valuation 2! 0 O 0.0 0 Park Support Fee # $
Permit Fee $ /_ 2-25' SAC # $
Plan Check Fee $ ([/,�_.. . Water Meter Size 5/8"; 1"; $
State Surcharge $ /. 60 Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ �5 I/ 5 Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ //7.. 7 5
This Application Becomes Your Building Permit When Approved Paid //j 7S Rec t No. !L✓/ 'Y
Date /0. 30. 1 B
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 proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(95.2)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372
04 Plzroie CITY OF PRIOR LAKE Date Rec'd
< HEATING/AIR CONDITIONING/FIREPLAC PERMIT
14 -
I.Pink File PERMIT NO /550
A'�nrvtso1� 2.Green City .
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS (office use)
11 24 ID rywri-E Art
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)
(Address)
APPLICANTIN
(Name) jlld+l,f- fT"_Lf[8LL. (Phone) _
(Address) 7CZ-62 -(4-hL y 53'Y.(j 'f Serin% Akt,. P�f Nnr0 5 2
(Contact Person) :1 (Phone) 1 - 1 $�Q -- Z3 Li
APPLICANT SIGNATURE DATE I- l '1 J )5
APPLICANT PLEASE COMPLETE BELOW
❑NEW CONSTRUCTION ❑REPLACEMENT ❑ALTERATIONS
FURNACEMAKE AND MODEL FUEL
FLUE SIZE RETURN OPENINGS INPUT OUTPUT
TYPE OF SYSTEM HEATING OR POWER PLANT PLEASE NOTE:Air Conditioner
❑
Warm Air Plants ❑Steam Units and Fireplaces Cannot Encroach
CI Gravity DHot Water into Required Side Yard Setbacks.
El Mechanical ❑Radiation Fireplaces with Box Additions or
11 Air Conditioning ❑Special Devices Cantilevers to the Outside of Buildings
❑Vent. System ❑Other Devices • Require a Building Permit.
FIREPLACE MAKE AND MODEL -- yl- also
Fa SCHEDULE
Industrial,Commercial &Multi Family I%of job cost Residential,Gas Fireplace $49.50
$49.50 minimum
Residential,Heating&A/C(New Construction) $149.50 Residential,Additions&Alterations $49.50
Residential,Heating Only(New Construction) $64.50 Residential,AC Only $49.50
Cost$ 30 Building Permit#
HEATING PERMIT FEE $ 49,5
STATE SURCHARGE $ 5`4F;.000a
TOTAL PERMIT FEE $
This Application Becomes Your Building Permit When Approved Paid 11111112:t,$t N-,41D
Building Official Date Date By INN.
24 hour notice for all inspections(952)447-9850 11
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
DEPARTMENT OF
LA,KEBUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS /74 c r AVE •
NATURE OF WORK ♦ /t, Lateet..
USE OF BUILDIN
PERMIT NO. Ar DATE ISSUEDr
CONTRACTOR s' , ` __ • PHONE 2 SO . 3 ��
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECTOR DATE
11111.1.11111.
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEA ► G
E
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
FINALS
BUILDING 5//-Z*
ELECTRICAL
PLUMBING v) C/
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections and
maintained until all inspections have been approved. On buildings and additions where no
service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850