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of r11104. CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE'OF ZONING COMPLIANCE Z ,
7cli
AND UTILITY CONNECTION PERMIT i 15d
lc',53 C
4r1Vtreset' I. white File PERMIT NO.
2. Pink City /5r /3/ z.
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
5ZZ6 11P-Al L aCAP L. -) 6C ?P-►oQ- LAY+ "0 553-12
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
O(Na )meER LPR f /°`A1Z1 AN) GlACC,95 (Phone)
(Address) 5126 (RAIL. REA() LN Sg p -ioR [.AIS MN 56-3`72
BUILDER
(Company Name) IN 1 D -CYDS (Phone)
(Contact Name) ?h1 i, iVlu>Z'CIt,A (Phone) /q
5Z'2l S-kag.bag. 6
(Address)' 500 VI cILS6w2.L-1 1./..1 W 1: 30- PLY?l40011k M ti 55411
TYPE OF WORK ❑New Construction ®'DeckPorch ORe-Roofing ❑Re-Siding ['Lower Level Finish ❑Fireplace
ElAddition DAlteration :MillConnection
CODE: R.C. ❑I.B.C. ❑Misc.
Type of ction: I II III IV V A B •
Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE S 30) U uv
(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 title and correct. I also certify that I am the owner or authorized agent for the
above-mentioned property nd at 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 can1,/, it'.r just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X , / 3c 636 in ity7,1 i 5
Signature Contractor's License No. ate
Permit Valuation 9 e e F - Park Support Fee # $
Permit Fee $ t 1 (_r-1 SAC # $
ll at
Plan Check Fee $ { ] Y't J Water Meter Size 5/8"; 1"; $
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 $ TOTAL DUE $ 2 / .,i I
This Ap;I do t ecomes Your Building Permit Wh n Ap,;t ved Paid a '9- •../1--- Receipt/N�o. 31(4—
4���A (� 27.,• Date /0.. ZZ -« By t,+'�-
'it 'no Otti. D<to
---
This
This into cip'fy that the request in the above application and accompanying docurents is i accordance with the City Zoning Ordinance and may proceed as requested. This document
when sig` , t City Planner constitutes a temporary Certificate of Zoning co pliance a d allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued. /
Plant _ ' _ . - Date Special Conditions,if any _
24 hour notice for all inspections(952)447-9850
4646 Dakota Street Prior Lake,MN 55372
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS 5 2z 77 -fre , ,tJ
NATURE OF WORK DEAF /,►. ,{
USE OF BUILDING _ � S /)172PERMIT NO. `.S e /J/2 DATE ISSUED /O. Z_Z_t`;
CONTRACTOR ? i-'i PHONE '952-. 245: 62:6
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECTOR DATE
FOOTING , ( Pc ----_
rior To Backfill)
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
\ 1
ELECTRICAL
441111101111110
.. .----- - TEST
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
„ ,. .
FINALS
BUILDING ,,.- ► a-
ELECTRICAL
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