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Building Permit 12. 1038
0 000000 7 0 0 k\ 2 - 0 0 � 0 , « k i / >CR m q 0 q / o a \ \ 0 M % � \\ \ Z- •• m 73 73 0 o * R 73 \ r 0 0 > \ a tn t 0 \ z 9 \ 0 b S \ / Z \ �x \ 2 _r w � � 0000 � . WI qt / m k 3 2 ■�e� §) c w n 0 m 0 a m m m ?3 m 0 n 0 x zo o @ - Exx Z m z _ m \ 7 > 00 0 0 3 § ICY z 0 ® / n r3 oo § 0 co a z �� 2 m § � � . \ \ / 2 k i P 0 Se 2 9 \ 1 0 � \ 0 rn , 0 mm 0 m § 2 k�� ∎ ƒ \ § J00 \ \ / \ E - � - k m n z § m ~ \� of pR � ° .p CITY OF PRIOR LAKE BUILDING PERMIT, '� TEMPORARY CERTIFICATE OF ZONING C MPLIANCE Date Recd LI AND UTILITY CONNECTION PERMIT �- �/ ��HNESOS� r 1 i -a- File 2 Pi Please , - or . rint and si at bottom) nA City y PERMIT NO f ...,3. ADDRESS Y ellow Applicant (.„, p . be N • W ZO G (office use) LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION P — I D .� 7 OWNER_ 3� �f� -� (Name) b ap B r K—US (Address) '3� (Phone) 95 Z (to - Z4 y S �a 1 4-$0001 L)Lt biz.. _ BUILDER i (Company Name) • j'' , �+ _a " _IA (Contact Name) ' 4... (P hone) I I-114- , 89 6 (Address) ( 3 1DPm _ (Phone) • TYPE OF WORK 0 New Construction ❑Deck . . ❑Addition DAlteration Porch L e- Roofing ❑Re- Siding ❑L.ower Level Finish ❑Utility Connection ❑Fireplace CODE: ❑LR.C. ❑LB.C. Type of Construction; II III IV V A B ❑ Misc. Occupancy Group: A B I Division: E F HI M R S U PROJECT COST /VALUE $ I 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 co .truction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building I offic an revoke this ,e ��i It for )ust, at/ Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections. ta / 4 1 4V Signature 8 C-(�►4 Zf�5z3 , D �� Bir 111111111 11, Contractor's License No. it Valuation Date p-w it Fee Park Support Fee # ©-- Plan Check Fee © . SAC # _ Water Meter Size 5/8 "; I " '- penait1, © Pressure Reducer Plumbing Permit Fee Sewer /Water Connection Fee # ., Mechanical Permit Fee Water Tower Fee # Sewer & Water Permit Fee © Builder's Deposit IUIIIIIIIIIIIIII IIIIIIIIIIIIIII Gas Fireplace Permit Fee Other ©_— TOTAL DUE ? _ ■ This Application Becomes Your Building Permit When Approved $ / Paid Aeizemin rj � � �� ,, Date G Recei.t No. 3, • 4,1/40" Buildine < � B cial 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 when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, issued y y a proceed as requested. This document must be V� Y. a Ccru ficatc' of Occupancy must be Planning Director Date 24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245 Special Conditions, if any 4646 Dakota Street Prior Lake, MN 55372