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Building Permit 14. 1112
C../ a 0 1 § F: E3E2 47 ui ww .4 0 § § � § § z z § _ 0 & wwk o 0 % § �� UJ0 0 § (9 t oOO❑ ❑ c § 2 u 0 Ce X U. C4 \ 0 . d §§ a • LIJ k Z q 0 ; E § § Li - o 0 o § o 0 w § izercecou- III a. 2 ' w § § co, 4 0 § § § § j§ i Qill 0ILI k I- ° k. a ■ ■ tea ■ �� W I ce z 000000 0 0 § % q - a a I- � IA ir § 11.1 w ` 1,,,,, o < A 0 © 0 a 0 �- 5 0 : : ■ 4? Zrq 2 § z u oz � �o w I- kfn 0 0 �4 44 �R co z kza - mak a z Ix ce B % o w w ■ w o o « w ■ ■ ■ o /K 0 § 0 u U u) 0 § o S a U 0 � 2 0 a 0000'0 O £ • of 1411°4%.; ie�o� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd , TEMPORARY CERTIFICATE OF ZONING COMPLIANCE p AND UTILITY CONNECTION PERMIT to , et, . (4 I. white File I PERMIT NO. ^ I 2. Pink City I . I I i , se type or print and sign at bottom) 3 Yellow Applicant 1 L Irk DRES i 55- l Lt(v `� 1 ,.Q.e,,,69\ SfZONING(office use) iso LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID b(0 . o()( „ C OWNER ad,( \ t"_ �� c/vl(Name) S, _ ` (Phone )-- T O O— c! U l (Address) -t ('1., e BUILDER _ v --_ (Company Name) th<� —� �Jt1 t wS (Phone) ( 0 I (Contact Name) l /t;(e S/C... 5 ,(?P (Phone) (Address) `"l )" `Zr , b ��� t^� j f ri \`L TYPE OF WORK 0 New Construction ❑Deck ❑Porch we-Roofing ❑Re-Siding ❑Lower Level Finish 0 Fireplace ❑Utility Conne tion CODE: ❑LR.C.4 ❑LB.C. El Misc. • e of Construction: I II III IV V A B 1j W pancy Group: A B E F H I M R S U PROJECT COST/VALUE . l ision: 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 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 revoke this permit for just cause Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. IX Signature Contractor's License No. Date Permit Valuation Park Support Fee # $ Permit Fee $ '7' SAC Plan Check Fee $ I 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 $ „r/ TOTAL DUE �� 6J�J Gas Fireplace Permit Fee $ ` This Application Becomes Your Building Permit When Approved Paid Recei.t No. iffrin_. Date /b, • 4 1 IF By Building Official Date s 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 signed by the City Planner consuhrtes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Cerhticate of Occupancy must be d Planning Director Date Special Conditions,if any 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street Prior Lake,MN 55372