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� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� D� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ,
" AND UTILITY CONNECTION PERMIT �. 2 --� •� Z—
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1. White File pERMIT NO .
z. P�� �,�Y % Z . � �
3. Yellow Applicant
lease e or rint and si n at bottom
ADDRESS ZONING (ofeice use)
5024 Ponsedge
LEGAL DESCRIPTION (oflffce use only)
LOT 4 BLOCK 2 ADDITION Deerfield 8th PID
�� � Bob Rude (Phone) 952-440-6183
(Address) 5024 Pondsedge
BUII,DER Superior Exteriors NII�T Inc. 612-382-2549
(Company Name) (Phone)
(Contact Name) S t even E 1 i e (Phone) 612 - 3 8 2- 2 5 4 9
(Address) 4520 Tower St . Edina, NR�T 55424
TYPE OF WORK ❑ New Construction QDeck ❑Porch [�Ze-Roofing ORe-Siding �Lower Level Finish ❑ Fireplace
�Addition ❑Alteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc:
Type of Construction: I II III N V A B
Occupancy Group: A B E F H I M R S U PROJECT COSTNALUE $ I� (') �C�
Division: 1 2 3 4 5 (excluding land) �
I hereby certify that I have fumished informadon on Hus applicadon which is to the best of my knowledge we and conect. I also certify that I am the owner or authorized agent for the
above-mendoned property and that all construction will conform to all elcisting state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can revo this it for just cause. Furthe:more, I hereby agree that the city official or a designee may enter upon the property to perform needed inspectioas.
X BC639129 �
ture Contractor's License No. Date � `
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 $
This Application Becomes Your Building Permit When Agproved Paid S ei t No. �"
Date 3� / L B
Buildin Official Date
This is to certify that the request in the above applica6on 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 consavction to commence. Before occupancy, a Certificate of pccupancy must be
issued.
Planning Director Date Special Condi6ons, if any
24 hour noHce for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakots Street S.E., Prior Lake, Minnesota 55372