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� � CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT 5. 2 /. /2—
*Illi
t. white File
z. y
Fell city PERMIT NO. .1z 46774,
(Please type or print and sign at bottom) 3. vett Applicant
ADDRESS ZONING(office use)
3 LI 5 S (2-C-e d 10 S , an.Or- L a k.Q OYl NI S s a 2
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER \
(Name) �J Vk,S A- r l F. V1_i b L e 01/4-v-ri (Phone) tP l Z 8 C0 S- -D 0 Co a
(Address) 39 36 efts2121 t)3 v-, Pr. L.Nr- -6k--k-e_ m ti S 5 31 2—
BUILDER BUILDER
(Company Name) A//A' pt,,Jv1-e r (Phone)
(Contact Name) c_VS-1"1,r-t Oa_ Xe l b L€U(-)O t (Phone) (OE T IO S a-,)Le 0
(Address) C -e c& �..J
TYPE OF WORK 0 New Construction [Deck ❑Porch ❑Re-Roofing [Me-Siding ['Lower Level Finish ❑Fireplace
❑Addition ❑Alteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. 0 Misc:
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ " t 7 -'--CD C)
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have furnished information on a,,lication 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....-...v*.. ' ' ...nform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can v' . •4, . j - caused f;,,s. „ore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X � ,vlA- 5/(x/2 v i z
�® Signature Contractor's License No. Date
Permit Valuation 3 0 C C> 00 Park Support Fee # $
Permit Fee $ .') c . ZS SAC # $
Plan Check Fee $ 57. 3 Water Meter Size 5/8"; 1"; $
State Surcharge $ / 5-0 Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other p�� $
Gas Fireplace Permit Fee $ TOTAL DUE 0, ��t/CJty S4Z2,I C $ /4- --
/ /
This ,,',. i., ' , Becomes Y ur Building Permit ' • ,A,• oved Paid /4-?•// eipt No. 6 3-3/C2....
4���, �� Date �.Z�,r —
Z
B " . _Offic. Date
This is to.. _ that the quest in the above a tTiion and accompanying documents is., . .. .. ce with the CityZoning Ordinance and may proceed as requested. This document
when :, e i .
constitutes a t ary Certificate of Zoning coraplian. d ail. construction to commence. Before occupancy.a Certificate of Occupancy must be
issued. '
Aphr ,fri� z7 (Z-
,g Direct. b: ' Special Conditions,if any
—""""6"...--- ' hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372
BUP DRNG A D�INSPECTION
PRIOR LAKE
INSPECTION
RECOR • - t�
SITE ADDRESS '�3S �;,.•(,J�i� SW.
TYPE OF WORK .D6e� /
USE OF BUILDING 12-es �}-/�
PERMIT NO. tZ - 451 DATE ISSUED S- 7( (Z.-
BUILDER
zBUILDER. .,‘.)s,YN 4.` �.`iLEzv-aa� PHONE # 2-p965-'cZ,,264o
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
L� ,� Fri Pb 'Ol/
I FOOTING I �j 3�zy��
PLACE NO CONCRETE UNTIL. ABOVE HAS BEEN SIGNED
-•41illhigilik- I I
I FINAL
FOR ALL INSPECTIONS (952) 447-9850