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Building Permit 13. 1043
0 000000 1 0 » E0 0 2 2 2 0 §�B �oo © § -o.K % r ri 73....dirw m x s mlc ,-co m m m mo tt 4o co g kr%k%k § i� CA /xp $ CO ■• ] 2 n 2 § f 7 / o 2 7 0 0 * 0 f 7 K o ■ t o a » S (�� z — co \ m k § q r § 7 I w / 7 m m m 0 z0 k ® 7 7 z m m IR 2 �1.... 00 0000 ƒ k � � � m� �Im� - 2 k k ƒ m \k2X1 ,30 to k .�■ z 2 z o 0 •m r -n 0 �K 0 0 § 2 0 2 2 71 m >cc r .. ii 0 1- '0 o x xim 0 m 2 73000000 LI % » t C) o pi ^ o '21 zhi § A -mm q „� -4E ■I z m -ir o I Q1 PR/0 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT q` Ze• /3 jNNES°� I.White Pile PERMIT NO. ( I 043I' 3.Yellow Applicant ' ease type or print and sign at bottom) DRESS Z G(office use) 1 CO 5S 1 � .�n\��:� 1i-A2\ $ 2. Pink City QK I S.5 LEGAL DESCRIPTION(office use only) A LOT BLOCK / ADDITION rr/OJ SO U'4 PID 075>0/7.-O©S" D OWNER (Name) 3 e 5ie jTIV N.Q_'rj (Phone) 6/.Z-o�p�21 2- 86 <1/ (Address) I(p 5-5-1 ri,/'(,tt14.1 K I 'e ir( 56, BUILDER 1c ( t ty (Company Name) a . YAC-[ V 5 CAVV '(7C-+i t (Phone) W- 4/0 / / (Contact Name)/M-�-I '{'�('V 51I 7--'\tt (Phone) 6O5/ - g"g5- 177 q (Address) 1 1 l0 /f vv c 51�E 4Lk , )e, 5 &4L o L/ M.0 3T O/7/ TYPE OF WORK 0 New Construction ['Deck ['Porch ' :Roofing ORe-SidingLower Level Finish 0 Fireplace ❑Addition ❑ DAlteration41;11 ❑Utility Connection CODE: ❑I.R.C. ❑I.B•C. ❑Misc: Type of Construction: I II III IV V A B `r oCo ccupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ ivision: 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 confo • .11 existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building official can r- • e this permit for just ..,se. Fu•..- ore,I opro -e that the city official or a designee may enter upon the property to perform needed inspe ions. Signature Contractor's License No. ate Permit Valuation Park Support Fee # $ Permit Fee $ 1' ( ` TS— SAC # $ Plan Check Fee $ J' D© Water Meter Size 5/8"; 1"; $ State Surcharge $ 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 / $ 17Q r / This Application Becomes Your Building Permit When Approved P�� �L e /-]/�' Receipt No.' 'QQ6 5, �� Z b• 13 Date S r z. ( � By SR iS_____ Building Offici 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 hen 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 ued. Planning Director Date 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