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��� �P CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
ti' / �,� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE �. 2 3� Z
" ��i ��J � AND UTILITY CONNECTION PERMIT
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�'NES�
' "''°� �''` pERMIT NO.
z � ��Ty 12 � 3c��
3. Ydlow Applicant
C83C OL BIItI � SL LOLIOt11
ADDRESS ZONING (osce use)
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/�� ? ���,�/�` C', � �S'�.
LEGAL DESCRIPTION (o�ce use onty)
LOT BLOCK ADDITION PID
�� � /fe�al, � ,� �6� �ho�� �S� S� 30
(Address) �p 7�0 �i�� � Il dl �f , . ���
BUII.DER �, / . - f�
(Company Name) y �' V�� � lO�P1r .T� c � (Phone) V'
(Contact Name) IJ/'/.c� �e/I�n (Phone) � �� � �y� �� 7y
(Address) � o X � o fem+u�.� � S�D
TYPE OF WOBK ❑ xew Const�uc�on �Dedc Opoxrh xe-xoosng �Re-Siding �Lower Levet Finish ❑ FSrepL�e
�Additipn ❑AlGaatian �Urility Caaaecuon
CODE: �I.B.C. �I.B.C. � Misc:
Type of Co�rction: I II III IV V A B ��JJ�'°
Occa�paacy Group: A B E F H I M B S U PR03ECT C�TNALUE S ��''�•
Division: 1 2 3 4 5 (egclading land)
I hereby cextify that I have famished iafamat�xi � dtis a�lica�on whid► is to the best of my imowle�e tcoe and a�a,t I also aenify that I am the owuer or � a�mt foz the
above-m�tioned pmpeity a� d�az all ooa�tion w�71 oonfi�m oo ati exi�g srate a� bcat laws a�t wil! pmaed 'm a000rdancs wkh �bm�ted pians. I am aware that the building
offiaal can revoke d' mix for just cause. Furthumom, I hereby a�eee that the official or a desi�� may enter upon du �o�erty to perfarm needed �s.
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X ��-- s�`-.-_", -� �D � � 9Ss'9 y /G - � �-
Sigoatune Canuactor's Lice�e No. Date
Permic Valuation Pazk Support Fee # $
Permit F� S SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ Pressnre Reduaer S
Penalry $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee � Buitder's Deposit $
Sewer & Water Pecmit Fee $ Other S
Gas Fireplace Permit Fee S TOTAL DUE S�
T� ��� �� Y�' ��g �� � Ar�� Paid t No.
Date r
Buildi Official Date
This is ro ceitiify thai the reqnest in t� above appliratioa and aacompanymg � is in a000rdana wYh du CSty ZaaioB maY P� as r�ed. This document
when sig�ed by the City Planner concrinues a tempoialy Oertificau of Zoumg mmpliance and attows mmst�ndiaa to commeace. Befae oaapancq, a Catificaoe of Oocupancy must be
issued.
�a�ing D� Cl�e Spacial C��o�, if �Y
24 hoar eotice for all inspectioes (952) 447-985Q, fu (9S2) 447-4245
A646 Dakota Street SE., Prior Lake, Mia.�oM 55372