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of PRt04 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
a c TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 8.. ., (5-•
. �- (5
tv AND UTILITY CONNECTION PERMIT
4/4vNEsOlt6 I. White File
2. Pink City . PERMIT NO. ` " ei3
3 Yellow Applicant
(Please type or print and sign at bottom)
t)O, ADDRESS ZONING(office use)
t SS i Z lZ IN of eek-4--
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID 451 lei. 003.0
OWNER (� Jam' I Ivor...4_— g rZ-L 4 L-'o 4 ,6-0
(Name) '"Y`D,A.., r^^--�Cj. .e-S (Phone)
(Address) 5-1 c 3o Sh--e.Q..a'
I
BUILDER
(Company Name) 40 Ani— o IA 1,....0.."--
..Q Y , (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding Lower Level Finish CI Fireplace
,Addition ['Alteration ❑Utility Connection
CODE: ❑I.R.C. ❑LB.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 t I have furnished informati.lon 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-memo p opetty an that all constru!ion 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 r oke is permi for just/ise F rthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X X
ig :tur Contractor's License No. Date
Permit Valuation t t, Ute_ Park Support Fee # $
Permit Fee $ 34-. 7g SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ t 5-0 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 $
35._ z...5-
This
sThis Applicati t/ s Your Building Permit When Approved Paid v S Z- Re 1pt No. Z� I
11/ � .3.15- Date 8, 3 (s-' B
Bt me fticial 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(952)447-9850
y 4646 Dakota Street Prior Lake,MN 55372
PRIOR LAKE- RNT O
BUILDEPADINGTMEAND INF
SPECTION
INSPECTION RECORD
SITE ADDRESS '
NATURE OF WORK FliJ- env
USE OF BUILDING
PERMIT NO. 3 DATE ISSUED
CONTRACTOR 7. fl,.-I. PHONEAVM)
INSTALL EROSION CON TOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECTOR DATE
ROMPONIMMIMMIN
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
dinaminiiimisme
FRAMING g \ - i 5
INSULATION r-1- 1-c-.
ELECTRICAL
PLUMBING
HEATING
.1111.11.1111
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
ori
FINALS
_ )
BUILDING 10A2-9
ELECTRICAL
LHEATING
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