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PARIj CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT (, ( I
44NESO1P I wine Flt PERMIT NO. 75
2 Pink City /¢` 3
1 Yellow Applicant I�
(Please type or print and sign at bottom)
ADDRESS Pork �/tONING(office use)
97/q r' cL-1 (et /1 L76 ScsG �e //S Cl
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID(-)-5 •. 1 `(1) 1"40
OWNER /
(Name) rQf 1 r�'t'1 1�c imp Sr 7V A ✓0 (Phone)
(Address)
BUILDER y( / t +�
(Company Name) De 5:clh e r �- j fl 59/�r L' G( t r`r't �-hL (Phone) 6Q(p." J 0 I - 2 v2
(Contact Name) .5 re.✓•e Fri,7�:/1-cr L (Phone)
(Address) 30> ( fa, b04iGl Lu n P h o r 4 Le k,
TYPE OF WORK ❑New Construction ['Deck EPorch ERe-Roofing ❑Re-Siding ['Lower Level Finish ❑Fireplace
❑Addition [Alteration ['Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑Misc
Type of Construction: I II HI IV V A B PROJECT COST/VALUE $ 5— OCCS v 00
Occupancy Group: A B E F H I M R SU
/
(excluding land)
Division: 1 2 3 4 5
I hereby ceitity that I have furnished information on this application which is to the best of my knowledge true and collect I also certify that lam the ownci of authorized agent for the
above-mentioned ,.: ty and that a consnuct in will conform to all existing state and local laws and will proceed in accoidance with submitted plans I am aware that the building
official can rev z! .et mit for ..use Ft t ermore,I hereby agree that the coy official or a designee may enter upon the property to perform needed inspections
e
r Signature Contractor's License No
Permit Valuation — s/M0 0 Park Support Fee #
Permit Fee $ /(7 i 2 SAC # $
Plan Check Fee $ ` 7/_ 'c' Water Meter Size 5/8", 1", $
State Surcharge $ 1..03 3 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 $ /9 ,-7
This Application Becomes Your Building Permit When Approved Paid /94-, It/ Recet No. '7i 21
Date - / ( By .
4 :6Z.A., .a.... ...‘,..."
Building Official D,Ic
This is to certify that the request in the above application and accompanying documents is in accoidance with the City Zoning Ordinance and may proceed as iequcsted This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows consnuction to commence Before occupancy,a Ceitificate of Occupancy must be
issued
Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
4646 Dakota Street Prior Lake,MN 55372
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PRIOLADEPARTMENT OF
BUILDING K
E A
ND INSPECTION
INSPECTION
RECORD
SITE ADDRESS 4719 pfq-/-6/6-
NATURE OF WORK / f 741/l5
USE OF BUILDING / (1 4/'
PERMIT NO. /Q': .3 DATE ISSUED �, /(Q,
CONTRACTOR Das/ J f l
�ti � PHONE (o (z, 5Z)/, gz¢Z,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
WENN
I I
111111111.11.1011.111.11111111
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
Sji --)/
ELECTRICAL
HEATING (if required)
=6.1.
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
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FINALS
BUILDING Siz/ 1 z/ // y
ELECTRICAL
HEATING t 7
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNEE1
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