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o f PR�-� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
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: AND UTILITY CONNECTION PERMIT
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I. White CityiPERMIT NO.r
3 Pink /.. /O�
3 Yellow Applicant LLL"'///
(Please type or print and sign at bottom)
ADDRESS P:;,,t-
ZONING(office use)
(50611 --tsl;t 1 t%
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER q 76 VCi t,c Tt,..oSU, (Phone) Gi�Z_ aZ7 6)1V)
(Name) p,`—t� 'r '
(Address) 15-06 FTS!^ pi- Y/�id. " s
BUILDERG-F— 1.--K1'-e-4;(<,
s tic.1c_i-1'cv, i Z-' MO �j'b�]6
(Company Name) (Phone)
(Contact Name) t,,'"-- (Phone)
(Address) 7-'t f,>(...-.t l C,vZk_ -;--✓ c. , .) c-S-23~
TYPE OF WORK ❑New Construction ['Deck ❑Porch ❑Re-Roofing [Me-Siding ❑Lower Level Finish ❑Fireplace
0.4ddition ['Alteration ['Utility Connection
CODE• R.C. ❑I.B.C. ❑Misc.
Type of onstruction: I II III IV V A B PROJECT COST/VALUE $ all,00° .W
Occupancy Group: ABE F HI MR SU (excluding land)
Division: 1 2 3 4 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 .roperty 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 actf"re oke' is perm for just c ise Furthermore,I hereby agree that the city official ora designee may enter upon the property to perform needed inspections.
Sig,y ture Contractor's License No. Date
Permit Valuation vIrl 49610 '
Park Support Fee # $
Permit Fee $ -341
• SAC # $
Plan Check Fee $ .2'56 1a Water Meter Size 5/8"; 1"; $
State Surcharge $ 11- .,/ Pressure Reducer $
Penalty $ 1 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 $ i1.;d 1'7
This 'pp ication Becomes Your Building Penni en A r.roved Paid � p Z1_ d� i/a7
Date /(e. /c. rReceiPJo.
By
V d Building s,-••' Da
This is to certify that the request in the above application and accompanying docu' ents is i accordance with the City Zoning Ordinance and may proceed as requested. This document
when Signe y t •City Plannelrconstitutes a temporary Certificate of Zoning co, pliance d allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issued.
i /e6 Lam,--fes. loll
]arming ire late Special Conditions,if any
24 hour notice for all inspections(952)447-9850
4646 Dakota Street Prior Lake,MN 55372
DRNT O
PRIOR LAKE BUILEPADINGTMEAND INF
SPECTION
INSPECTION REDORD
SITE ADDRESS t W (�' fc 5 b�S F00-1"
NATURE OF WORK A-01 (T(
USE OF BUILDING iN
D
PERMIT NO. . - 10 ATE ISSUED (t. Ib
CONTRACTOR 114'r 11&160 PHONE r t-t. - 4 9W 2W
INSTALL EROSION CONRTOL AND MAINTAIN CLEAN STREETS AT ALL TIMES
INSPECTOR DATE
FOOTING
- TII5N (Prior To Backfill)
ER
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
VrtillialaWMEPTIC
FRAMING 3 \ )k
INSULATION
ELECTRICAL
HEATING
T Adamicv
COVER NO WORK UNTIL THE ABOVE HAS BEEN SIGNED
HOUSEWRAP
FINALS
IOR TO SODDING)
BUILDING ,t-f (0 1�
ELECTRICAL
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections 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