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ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
T~~~~RY CERTIFICATE OF ZONING COMPLIANCE
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City
AppllCa11l
I PERMIT NO. 07.08:12- I
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ZONING (office use)
LEGAL DESCRlPTlON (office use only)
LOT
BLOCK
ADDITION
PIDb .Z-~4-01.()
OWNER
(Name)
(Phone)
(Address)
(Phone) 1"52..crZ -5 -61 %
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch
OAdditlOn OAlteration o Utility Conne
e-Roofing
IOn
ORe-Siding
OLower Level FinIsh
o FIreplace
CODE: OI.R.C. OI.B.C.
Type of Constmction:
Occupancy Group: A B
Division:
o Mise
I
E
II
F
I
III
H
2
IV
I
3
V
M
4
A
R
5
B
S
U
PROJECT COST /V ALUE
(excluding land)
$
Contractor's License No.
Permit Valuation
Permit Fee
$
$
$
$
$
$
I $
$
Park Support Fee
SAC
#
#
$
$
$
Plan Check Fee
Water Meter Size 5/8"; I";
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
BuIidlllg Official
Date
Pressure Reducer
Sewer/Water ConnectIon Fee
#
#
Water Tower Fee
Sewer & Water Permit Fee
Builder's Deposit
Other
Gas Fireplace Permit Fee
TOTAL DUE
This Application Becomes Your Building Permit When Approved
TIllS IS 10 certify that Ihe request 10 the above applicatIOn and accompanYll1g documents IS 111 accordance WIth the City Zoning Ordinance and may pruceed as requesled TIllS document
when signed by the CIty Planner constItutes a temporaty Certificate of Zonll1g compliance and allows Cllnstruction to commence Before occupancy, a Certificate of Occupancy must he
isslled
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any