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OrFPRiciCITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
lrj
I. while File PERMIT NO. \'a' _4-�
��HNE50� 2. Pink City \ c\
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING((lfice use)
I -7Zo ( SLo45e-( A-vcelue, , ShetiGp WIN C- 3-25
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER •
4�✓C�d C.l.id V-eV1" � (,CSS i S Z -t-e46 -04 i/
(Name) � '! ,„ (Phone)
(Address) 1 —7 ZO I (..�,fil4.2-1 4v 6111-U e ` S Y.F2 19e. I4'L J c S-3-)`'7
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK New Construction ['Deck EPorch [Me-Roofing ❑Re-Siding ['Lower Level Finish ❑Fireplace
['Addition ❑Alteration ❑Utility Connection /
0-Misc.dd-fa c,4ecrl 6arsc.o2.
CODE: til.R.C. ❑I.B.C.
Type of onstruction: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: A B E F H I M 2 3 4 R SU (excluding land)
Division:
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 hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
Contractor's License No. Date
X
Signa e
Permit Valuation KO. 067
— Park Support Fee # $
Permit Fee $ ( SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ Reducer $
Penalty $ 7r 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 $ .42.4.,„ 3
This pplicatioo B co a Yo r Building Permit Whe Appr,ved Paid Li_ go . Receipt
1_ Receipt No.
Date 536'/I- By ..,.f/1 L.W
• Fac 7r „Z"
t
Buildine Ofticia bate •
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 t porary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
�
issued.
,.3I,Rp.
. .d 'anning Dir or Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372
4'
0 WI White -Building
Canary -Engineering
' vxBso�' Pink -Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT V1Z — SST"
APPLICATION RECEIVED •-•-n60‹i,,,r5 c)`J 5-/.;}? /4-
The
¢The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
• –7 &, , , f�cJ• ate
Accepted Accepted With Corrections
Denied
Reviewed By: �T F Date: /1"
Comments:
_ A t/rs 0AL_ 4\15Per---T1 d f‘J C rcf
& �('fiz� c v,4r/7-Aj /ky
�f£-c /S krek,s,1 /Sa--47J(
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
geE
Y$10White -Building
Canary -Engiil�t�eerin4roan ottPink -Plan`Ifig '`71
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT r1 /14
APPLICATION RECEIVED _ 60<7-01.F5 c>"/ 5 A f¢
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
2-c9 "� •
Accepted `' Accepted With Corrections
Denied
� ----
Reviewed By: 1w Ifi<�'�'i_ Date:
Comments:
'mak
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
4
PRIOR LAKE DEPARTMENT OF •
BUILDING AND INSPECTION
INSPECTION RECORD
SITE ADDRESS (7 2-c)( r CSN �6
NATURE OF WORK 7
USE OF BUILDING
PERMIT NO. (4- 4 DATE ISSU f •
CONTRACTOR r5,4gp C�5''s�c-5'on/ PHONE za-
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES!r
E. . 7-J/'/4 O/ t Pc4°A/� f�/L� INSPECTOR
DATE
FOOTING ( 1�J ` �
SMIIIIIIIIMPrior To Backfill) `
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING � yi Zc)' l�
INSULATION
ELECTRICAL
11111111111111111111.
. !
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
HOUSEWRAP MOW
FINALS
GRADING ( PRIOR TO SODDING)
BUILDING pt44, v
ELECTRICAL
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspectiors,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