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ADDRESS
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CITY OF PRIOR LAKE BUILDING PERMIT,
JvItJ ~~ORARY CERTIFICATE OF ZONING COMPLIANCE
",- ~)('-I( AND ~~TY CONNECTI02, ~PI'nk~E~cdltey T
V 3 Yellow ApplIcant I PERMIT NO. 0 7 - 01 z-- I
1 S u.. ~ LN
Date Rec'd
ZONING (office use)
LEGAL DESCRIPTION (office use only)
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LOT \)3LOCK ADDITION
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PID '2 - 300-071 - 0
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BUILDER -~<:s
(Company Name) .s~~~ ~~~~~, ~~'-
(ContactName)c.....L:t.N~ CS C-~~~
(Address) (3 ~ \N c\. S\' ~~N ~~~
(Phone)(~~11- ~~C) -d----~\\ ~
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TYPE OF WORK 0 New Construction DDeck DPorch '1izlR.e-Roofing ~e-Siding DLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connehk;n
CODE: OJ.R.C. OJ.B.C.
Type of Consttuction:
Occ:upanc:y Group: A B
Division:
o Misc:
I
E
n
F
1
ill IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST IV ALUE $ \ ~ ,(:)\:xJ?
(exc1udiDg 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 construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
~~'Ih<reby__"citr~m~r~~g?;<h'_m_:gr~rO '\
Signature Contractor's License No. Date
Sewer/Water Connection Fee
#
#
$
$
$
$
$
$
$
$
$
70. -
Permit Valuation
Permit Fee
?-
Park Support Fee
SAC
#
#
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
\ ,2-'--
Water Meter Size 5/8"; I";
Pressure Reducer
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
I Paid "1 ~- --
Date 7 '2- Cr, r 0"1
I ~;ceiPt NO(~tL~~
This is to certify that the request in the above application an 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 uotice for aU iuspectious (952) 447-9850, fax (952) 447-4245