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04 PRI0
4\,, AN�'� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
U
AND UTILITY CONNECTION PERMIT
4"r�'NE5���
1,white File I PERMIT NO. I
2. Deno City / •(
(Please type or 3. Yellow Applicant
print and sign at bottom)
ADDRESS
i 4 67 10 cry li II
, i r°(,<' 1 S'.
ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER r-
66(Name t hi/ill ro.°I 0tC C .vt'vn (Phone)
retri 95Z qq7 z.5.1,5"..(S
*/7(Address) 1 6/7( � h kI))I1 ---1. � S� Pr.or
BUILDER
(Company Name) S 13 D 1 S.s9 h S (Phone) Ci 5 Z. z.Z q Cj.qac.
(Contact Name) S eCt In S nde r" (Phone)
(Address) 16 sa}T 6:a s,ti,.G c rel..., / c
TYPE OF WORK %New Construction ['Deck ❑Porch ❑Re-Roofing ORe-Siding ❑Lower Level Finish ❑Fireplace
Addition DAlteration ❑Utility Connection
CODE: ❑I.R.C. 36.C. AtMisc: S i in h S4Gi 11
Type of Construction: I II BIN V AB 7
Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $ /Z- 00
Division: 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 co .rm 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 p ' or just cause. Furthermo ereby. e that the city official or a designee may enter upon the property to perform needed inspections.
X ..-^1C — ////q//3
Sia attire Contractor's License No.
Dat
Permit Valuation 00 O, _ Park Support Fee # $
Z-,
Permit Fee $ $
2.2-1, , SAC #
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ � �3��5
4 , . 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
$3Zo. LS
This Ap icat, Be .mes Your Building Permit n ;roved I Paid
�� �l.- &(DS Receipt No. ""�j J 11 'b ri
1'// �ii!�L �Z L r Date l Z�: i I BY c- -t.1�.:
.B'ilding Official Date APpQOVED
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.
lZ/USb I2a
Planning DtrectDirect() te
Special Conditions,if any
-..._. 24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
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46. X :
DEPARTMENT OF
PRIOR LAKE BUILDING AND INSPECTION
INSPECTION
RECORD „
SITE ADDRESS C0(910 hZA L, 3 i �. S. C.
TYPE OF WORK St c_N
USE OF BUILDING t
PERMIT NO. 3 . 130/ DATE ISSUED 124/3
BUILDER SD� SI ci-5S PHONE # 15Z • ZZ k .`►�o�
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECT° DA E
I FOOTING ` / ���
f
PLACE NO CONCRETE UNTIL B E HAS BEEN I NED
I FRAMING
I FINAL
FOR ALL INSPECTIONS (952) 447-9850