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Building Permit 14. 1221
IL 0 - E 1� k re 2 §v2� 2 % 2�2&� 0 § li §5.58 § 2 \ ocOCOO o 0 2 x UJ CO t 0 k O � � k z § E I tu 22I -J 0 t 0 § o 2 � _X22Z k \ 0 UJ ƒ � $ w � § 2 2wU 2 ■ g = ■ U@23u w w & 2 / \ ® §$ ■ a § ��� 0 p ■ w ~ oOOOCO �� k ƒ / a a 2 N 4 @ § w w « U. cc / 0 § (3 S 2 0 7@ 2 § 4j $ p $ S § \ % & j - / 4. k ■2 ® . o §_ w ` & o O -J 2 § 6 2\k © UJ Isl r3 CZ f8 k E a.0U co - UJ in §�X4C§ 0 � ° ° $ �a § � § E2$■ ■ § 0 ❑ O O £ k2 2 o 1000000 U CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd OF PRIp4. � TEMPORARY CERTIFICATE PERMITONING PLIANC E F AND UTILITY CONNECTION V 1. White File PERMIT 2. Pink City ��NNES��� 3 Yellow Applicant se .e or trintand si: at bottom) ZONING(office use) • DDRESS LEGAL DESCRIPTION(office use only) PID i `r LOT BLOCK DDI %" - , - J 'V S N - /4116 (Phone) G • ' cl . OWNER (Name) (Address) ST 7i) ..r • " , °'' ( r- BUILDER �c (Phone) I (Company Name) ' (Phone) (Contact Name) (Address) t liN TYPE OF WORK 0 New Construction ❑Deck ❑ Porch 5'e-Roofing ❑Re-Siding ❑Lower Level Finish 0 Fireplace DAddition ❑Alteration ❑Utility Connection ❑Misc. I R.C. ❑I.B.C. �+ CODE: ❑ . I II III IV V A B PROJECT COST/VALUE $ e of Construction: A B E F HI MR SU (excluding land) panty Group: 1 2 3 4 5 inion: upon the property withtperform needed inspections_ aw to all existing state and local laws and will proceed in accordancesosubmitted plans. I am aware that the building 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 or c I hereby 1v anditthat all use. a rihe will conform above-mentioned property agree that the city official or a designee may enter official can revo this permit for st cause Furthermore,I hereby Date X Contractor's License No. I � Signature Park Support Fee # Permit Valuation Permit Fee 11111111111111111 Water Meter Size 5/8", 1", lgIIIIIIIIIIII Plan Check FeeIINIIIIIIIIII Pressure Reducer IIIIIIIIIIIIIII EgaZZMIIIIIIIIIIIMNIIIIIIIIIIII IIIIIIIIIIIIII Penalty Sewer/Water Connection Fee # _- Water Tower Fee # 1111111111111© Plumbing Permit Fee Builder's Deposit Mechanical Permit Fee gIIINIIIIIII Other 1111111111111111 Sewer&Water Permit Fee $ TOTAL DUE Gas Fireplace Permit FeeIIIIIIIIIIIIIII 111111111111111 Li�� A This Application Becomes Your Building Permit When Approved Paid Recei.t No. !, B a Date Building Official Date a e Certificate of ed.OcThis y must be to cern that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. Thisdocument is certify signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. • tied. Planning Director Special Conditions,if any Date 24 hour notice for all inspections(9q-2)447-9850,fax(952)447-4245 4646 Dakota Street Prior Lake,MN 55372