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Building Permit 15. 1345
E cV C) O 0000 1 0 > 2n i n 0 ■ § 2 -n -n '1.1 0 § § �q CI III / k § m � � � � � � �� -4 -1 » 2 $ -oma ® Z■ ® t a m2 0 ■ 0 2 pi 0 00 § kx \ 0 Xl , / 2 ' ` X r z 3 3 % m o 73 72 Z � R R ' 000000 m m m m ��k_ � 2 � t � � 6 9 x m m ) \ \ f 0) ' � OC -IOC m 0 A g-. 0 z �zAA - 41z m § z n w " TI -a 0 m ■ 0 m / & m cO ❑ OCO R.▪ ■ o " Fanm §Z m2K)% © �mo ® E13 -o -0 % >WWI 555 § ® n » AA ■ m V qm { 55 -n � � F - E m i 0 �. C Pxio� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 4 J AND UTILITY CONNECTION PERMIT ES��� I. White File 2 Pink City PERMIT NO. t 5,:fi.:1-fi 3 Yellow Applicant (Please type or print and sign at bottom) ADDRESS ZONING(office use) 3u2o' _57cq - o7-" r, Gl_i l LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION PID OWNER !1{� d G?/ 'h ,5' / (Name) 4 11 `l f'e,g " 4 7 (Phone) ,Z- 3- /7-Jo 4 (Address) BCompanyy Name) A ( e 61, --7,t- 5 I---- (Phone) 1J.-- - 1. `e I Z 7 (Contact Name) f c f -e_ I/ ,(-c, c is (Phone) e t Z - Z eZ - 77,3 ,1 (Address) 3 6 .'2k, ; e 1,) e cz C It r 5. ; TYPE OF WORK ❑New Construction ['Deck ❑Porch [Me-Roofing ❑Re-Siding ❑Lower Level Finish El Fireplace ['Addition ❑Alteration ❑Utility Connection CODE: R.C. ❑I.B.C. El 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 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 ereby agree that the city official or a designee may enter upon the property to perform needed inspections. Signature Contractor's License No. Date Permit Valuation ,2-40,19e) / Park Support Fee # $ Permit Fee $ 7 31 SAC # $ Plan Check Fee $ 47 d4 Water Meter Size 5/8"; 1"; $ State Surcharge $ -- Pressure Reducer $ Penalty $ Sewer/Water Connection Fee # $ Plumbing Permit Fee $ �© `5-b Water Tower Fee # $ Mechanical Permit Fee $ Builder's Deposit $ Sewer&Water Permit Fee $ Other $ Gas Fireplace Permit Fee $ TOTAL DUE $ il3) t 61 P This • t i icat in Bec i is- • - - _Permit Wh n Ap roved Paid / 73..` 9 Rece t '72_ Date /l 7 L� By wilting Ofticta 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 4646 Dakota Street Prior Lake,MN 55372 Oi PR/04 Date Rec'd Nv CITY OF PRIOR LAKE PLUMBING PERMIT `l 5- /5 ,. Blne FA PERMIT NOff�r� ,, 2.Gold Cit 3. Yellow Applicant L �� (Pleasepe or print and sign at bottom) ZONING(office use) CGs ja-/frz,0 LEGAL DESCRIPTION(office use only) LOT BLOCK ADDITION p� OWNER *am) (Phone) (Address) Vie) ) ANT 41n, 'Z-� /v✓t^t b `` S hone �' �Z 4/G/O— 3 Address) Sri /'"7 6-440 0�.v Z. �2. c L..NA n. E (Ad ress) (City) (Zip Code) ntactPerson I�ILL1-IL/'— /49-(J� ' ( ) (Phone) APPLICANT SIGNA DATE I / APPLICANT PLEASE COMPLETE BELOW Quantity Type of Fixture Quantity Type of Fixture Bath Tub with or without shower Rough-ins Dishwasher Water Heater Floor Drain Water Softener Lavatory(Bathroom Sink) 7( . Stand Pipe(Washing Machine) Laundry Tray(1 or 2 compartment sink Sewage Ejector Shower Stall Backflow Assembly Sinks Backflow Assembly Test Bar Sink Lawn Sprinkler Water Closet(Toilet) Other FEE SCHEDULE Industrial,Commercial&Multi-family 1%of job cost with a$49.50 minimum Residential,New One&Two-Family $149.50 Residential,Additions&Alterations $49.50 Estimated Cost $ Building Permit# PLUMBING PERMIT FEE $ STATE SURCHARGE $ .50 Ai to. TOTAL PERMIT FEE $ (Office Use Only) �'A Wirti This Application Becomes Your Building Permit When Approved Paid Receipt No. ' Date By Building Official Date 24 hour notice for all inspections(952)447-9850,fax(952)447-4245 4646 Dakota Street S.E.,Prior Lake,Minnesota 55372 PRIOR LAKE DEPARTMENT OF BUILDING AND INSPECTION INSPECTION RECORD SITE ADDRESS GR44. NATURE OF WORK USE OF BUILDING PERMIT NO. ‘r- DATE .SSUED •CONTRACTOR g i �c K. 7 .,c PHONE ("2 . 21 2, - 71 INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES Z4 TOR 7 FOOTING JO/ 1 111111111111111111111.1 (Prior To Backfill) PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED ROUGH - INS FRAMING \(5- INSULATION 6NSULATION " 1 l 3 ' 1, ELECTRICAL PLUMBING �� ` £ ` r HEATING \�\11, (�--- GAS LINE AIR TEST aiii.111111111111101111111111. COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED FINALS BUILDING t-1\ ELECTRICAL PLUMBING 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