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Building Permit 12. 0481
5 0 0 n 000000 0 > z2 n 0 k 000 . 0 gz0) -n 11 it00 § m q 24 » © 21 73 xi c m >cEk§ m x § omq to r � ' q § m Z � zuvz ■ 11 CO k t 2 % § logo P �§ tp w H . r k 0 ` z q t ° § 2 , a. 0 m m 73 X r § .ai ( . 02 �� z �` 0 R 000000 • m mm m ■� ■ ■ � k K 0E � 0E e. $ / § / § } m 73 73 "CO 0 CO z ` % § / / , r \\\ / 2 / 0 % SD 2cc z r k K m � 13 TIP § 0 I ii zi = 0 •-....0 § 0 tONIMO 6 000000 2 z z §2 § si R. ° 110 1100.M. 11, 22 § §-� ° i . E\ K § - 0 § 00 —1 k/z § (0c PR/04, CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE . • AND UTILITY CONNECTION PERMIT v m I."''it` Pile PERMIT NO. zM,NKES�� 2. Mink City / . V / 3 Yellow A• pplicant (Please type or print and sign at bottom) �/® j� ADDRESS 3-q& q ,g Ci��i�64,.._ ZONING(office use) J( �a' I1 S7L LEGAL DESCRIPTION(office use only) LOT / BLOCK ADDITION PID OWNER // s yDa� (Phone) 45Z. 7 97 6'2 / (Name) je V �. (Address) BUILDER • (Company Name) TY GA II I / �, j) , (Phone) (Contact Name) (1Ab V o .s FF /� (Phone) y�/� Address 5550 L�I'�.(/1/`e� 0 / l fo I ' 55•(_ . TYPEOF WORK 0 New Construction ODeck ❑Porch ORe-Roofjng ORe-Siding OLower Level Finish 0 Fireplace ..__ [ ' OAdditton OAlteration OUtility"Connection Misc.• (,491CODE: DI.R.C. DLB.C. PROJECT COST/VALUE $ Type of Construction: I II III IV V A B (excluding land) Occupancy Group: ABE F HI MR SU D � ) A,,",,,�a�►L „dA'. ' L Q�` itDivision: 1 2 3 4 5 1 / ` '(3/ LKCJ�/114 ,,,e10 "'�` , ��' ' " i1 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 authorizednt for theabove-mentioned property and t - all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware thae building official can revoke is permit f. ca e ermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. X I I t • a eon 17.3/NArzI//5-o 5//,iz >gna gnature Contractor's License No. Date Permit Valuation Park Support Fee # $ Permit Fee $ -14,75 SAC # $ Plan Check Fee $ Water Meter Size 5/8";1"; $ State Surcharge $ 5 .p0 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 $ /S149.75 This Application Becomes Your Building Permit When Approved Paid /q, "7,1--- _!, 7( l R ipt No. e‘), 47 Date J d-r_`/7 , I B Building Official 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,fax(952)447-4245 16200 Eagle Creek Avenue Prior Lake,MN 55372