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Building Permit 15. 0830
- c O n 000000 -a 0 a E0 2 © 8 2 q2-gPIR I m 1 534 k p n m m k M ■ P & Ek§ z a) kII r 2 El ■ 2 $ §B � Q P z / t 0 a § CD ° z z . z ■ q z -1 z 0x 8 n > 0 7 2 r z 7 z z 2§ § 000000I X q m m m13CAtEII c c ~ T § ■ � i § m O . Cl) | ■ ? m l _ � - � - - 0 g 21 0 � - r- 0 6)6) k -4 { m § 0 , § f C C § 0 m z R m L o / X 2 X sm A I) ?a' m C j K 073 73 2 � mm 0 4, m D 0 0 I00Et) § xmx � r -1 ' -Iz - § § 4r 0 of PRtp� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd y ; TEMPORARY CERTIFICATE OF ZONING COMPLIANCE V AND UTILITY CONNECTION PERMIT 7 ZJ /S^ 4�NiYES.._ I. White File 2. Pink City PERMIT NO. D t 3 Yellow Applicant ,/ (Please type or print and sign at bottom) ADDRESS , ZONING(office use) loci (0 _�_ Ls? c..") LEGAL DESCRIPTION office use only) LOT BLOCK AD ION PID ��'V75— Oil'D ° 4 ' V (; g)•'—'44-7--'�5��7 (Name) t 1 (Phone) (k) (Address) BUILDER (Company Name) (Phone) (Contact Name) (Phone) (Address) TYPE OF WORK ❑New Construction ['Deck ['Porch Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑Fireplace ['Addition ['Alteration ['Utility Conn t n CODE: ❑I.R.C. ❑I.B.C. ❑Misc. Type of Construction: I II III IV V A B PROJECT COST/VALUE $ Occupancy Group: A B E F H I M R S U (excluding land) Division: 1 2 3 4 5 I hereby certify tha 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-me .ned aper. and that all constr.......... ill conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building officia c ' r volt t 's/riiit for just c i• ;-74 ore,I hereby agree that,the city official or a designee may enter upon the property to perform needed inspect ms. Signatur i,f Contractor's License No. ate i Permit Valuation Park Support Fee # $ Permit Fee $ SAC # $ Plan Check Fee $ Water Meter Size 5/8"; 1"; $ State Surcharge $ 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 $ 75 73 This Application Becomes Your Building Permit When Approved ` ' 75-, 1,S Receipt No. V..9.. 1 Date n ` - By r L� 1 5 ...t5' Building Official 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 proceed as requested. This document when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be issued. - Planning Director Date Special Conditions,if any 24 hour notice for all inspections(952)447-9850 4646 Dakota Street Prior Lake,MN 55372