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� �, CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
`'� AND UTILITY CONNECTION PERMIT
�
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1. White File pERMIT NO . �� �
2. Pink City
3. Yellow Applican[
lease e or rint and si n at bottom
ADDRESS ZONING (ott'ice use)
3234 Kent St SW
LEGAL DESCRIPTION (oftice use only)
LOT 3& `�LOCK 29 ADDITION spring lake townsite PID
�� � Steve Vanek (Phone) 952-217-3066
(Address) 3 2 3 4 Kent S t SW
BUII,DER Superior Exteriors MN Inc. 612-382-2549
(Company Name) (Phone)
(Conta.ct Name) S t even E 1 i e (Phone) 612 - 3 8 2- 2 5 4 9
(Address) 4520 Tower St . Edina, NI1�T 55424
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch [�te-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 IV V A B
Occnpancy Group: A B E F H I M R S U PROJECT COST/VALUE $ 9, 10 0
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have fumished 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-mendoned 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 buildiug
official can revoke pe it for just ause. Furth ore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X BC639129 5/31/12
Signature Contractor's License No. Date
Permit Valuarion Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surchazge $ 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 $
Tlris Application Becomes Your Building Permit When Approved Paid ei t NO.
Date i� <
Buildin Official Date
This is to certify that the request in the above application 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 constructlon to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Directar Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Mfnnesots 55372