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of PRiO CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
ic CERTIFICATE OF ZONING COMPLIANCE 4L ,., /3
.. x AND UTILITY CONNECTION PERMIT
U ell ~4NESO�� I. white File pink A PERMIT NO. / 5
3 p
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER �, _ ' �, ,� p / _ /
(Name) GV7 >,� Gt J C��vC/'�_ (Phone) ___ — __[3 I Br
,a2_
,s' (, 7 S .--- A+(io f,t E G(
1 BUILDER , ,,, �I',_,� G
(Company Name) , C k_ cc r* &i Y1/4.) CO (Phone) cD (z i6 1 —13z � S �
(Contact Name) LA t'W -( `'r
s ZJ 5 (Phone) c re....---.763 — O I W /
(Address)
TYPE OF WORK ❑ New Construction Deck ❑Porch [Me-Roofing ORe- Siding ❑Lower Level Finish ❑ Fireplace
❑Addition DAlteration ❑Utility Connection
CODE: DI.R.C. DI.B.C. ❑ Misc.
Type of Construction: I II III IV V A B PROJECT COST /VALUE $ r�
Occupancy Group: A B E F HI MR S U (excluding land) C l �
Division: 1 2 3 4 5 t
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 1 am the owner or authorized agent for the
above - mentioned proper and that all construction will conform to all existing state and local laws and will proceed in accordance web submitted plans. I am aware that the building
official can revoke thi .ermit for Just '-•ermore, I hereby agree that the city official or a designee may enter upon the p etty to perform needed i spe Lions.
15 i
Signature Contractor's License No. i Ce
Permit Valuation 0 0 0 _ 0 0 Park Support Fee # $
Permit Fee $ 8 0 a5 SAC # $
Plan Check Fee $ , j 7_ 3 67 Water Meter Size 5/8 "; 1 "; $
State Surcharge $ L. SC). 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 dJ'at v" 1 4/c I i a $ /i _7 //
This Apt ic. i n Becomes Four Building Pe it en Approved '� ���(� Recei't N �'`' �
i I "2 D.te B - j
• t (ding 011 , Date
This is to certify t . the r •uest in the above application and accompanying docu' ents i• in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by t . it ' I nner constitutes' temporary Certificate of Zoning co plaan■ and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
' ,
in Director a ate Special Conditions, if any
24 hour n tice for all inspections (952) 447 - 9850, fax (952) 447 - 4245
646 Dakota Street Prior Lake, MN 55372
PRIOR LAKE BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS ZSOS /NWK feaOGjFi AU.
TYPE OF WORK DECK
USE OF BUILDING ILES4�/t
PERMIT NO. I3 . 2.59 DATE ISSUED ¢. 3. 13
BUILDER A/LOffNDEC� PHONE # (0/Z. 41.332.6
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
FOOTING r ram
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
*Ma t
I FINAL 1 er 5/29A__.31
FOR ALL INSPECTIONS (952) 447 -9850