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,,,��' �\`���, CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
�� �`. `� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
"�` ! �` � �' AND UTILITY CONNECTION PERMIT � . /¢ : / Z—.
,`_' �
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2: � "k �;ry PERMIT NO. // !��
s. vel�ow nppliaet / � - / /
C88C OT 3II� � S� bOttOm
ADDRESS ZONIl�TG c� ��
�� l � ���i�ivv/ �ic/.
LEGAL DESCRIPTION (oflc�ce use onty)
LOT BLOCK ADDTTION pID
�� E G ��i �5f S Z — � O — ( $OZ
(Phone� �
�aaa�s� 't`t 9' S �st,uv7� �n e �(Z.'a�L�e IN'? �
sua,n�
(Company Name) �der� �'v� r �et N (�o /�; ....r (Phone) �.o S � - at.a`f ' 313� .
(Contact Name) SG.•••� �..�.-. (Phone) � 5 ! - 5� Z- y O� 9
(Address) !�'C..�nt►''t !7•:�7�" G�v/'✓C '�`Zt�o !�f-. ���� 1^^� l� � 5S 1�-�
TYPE OF WOBK ❑ lvew Consmiction QDeck ❑Porch -RoofmB �ReSiding OLower Level Fmish ❑ Fireplace
DAddition �Alteration �Utility Connection
CODE: DI.B.C. �I.B.C. ❑ �;
Type of Consavction I II III IV V A B
Occupanry Group: A B E F H I M 8 S U PBOJECT COSTNALUE S 5 ��
Division: 1 2 3 4 S (ezclading land)
I haebY arofY that I have fiunished info:mation oa this application wLich is to the beu of my Imowledge tnu and coned. I also cadty tLat I am the owaer or aWLorized
agent for the
above-meationcd property and that ali coasttuc�aoa wtll Confoim to all eAStl,ng stau and locat laws and w�71 procad in accordance with subnoitted plans. I am aware tl�at the building
offiaal caa revoloe this pemrit for just cause. «mae. I haebY agree that the aty o�rial a a designee may mar upcm du propeKy to pafotm naded'mspeaiams.
$ G ��7 Zt.o 5 g-� z
S�� Contractor's License No. Date �
Permit Valuation Park Support Fee # $
Pe:rnit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ Pressure Reduoer $
P�tY $ Sewer/Water Connecoion Fee # $
Plumbing Permit Fee $ Watex Tower Fee # S
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ �Other $
Gas Fireplace Peimit Fee $ �,�, D� $
Tws npp�;caaon Beeomes Y�a sadtdtng perm�c wben.wpprovea Paid t No.
Date . 2�-
Buildin Official Dste
This is to ttctify tl�at the request i¢ the above applicadon and acwmpanying documeat� is ia acoordaaa with the City Zoning Ordinana and may �rooeed as requeate4 This documeat
whrn signed by che City Plaana coasatutes a kmporary CertlRcate of Zoning oompliana aad allows cafst:ucdon to coanmence. Befaa�e occupancy, a CadBcate ot Occupancy must be .
issued.
Planniag Director Dau Spocial Condiaons, if �ty
24 honr notice tor all inspcctions (952) 447-9860, fu (952) 447-4245
4646 Dakota SMet SE., Prior Lake, Minneaota 553T2