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� PRIO ,
�o '�� CITY OF PRIOR LAKE BUILDING PERNIIT, Date Rec d
� � TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
" AND UTILITY CONNECTION PERMIT
�
j �'NES��
'. wh„` F��e pERMIT NO. l ,�,(/ �
2. e�c ctty L� 7
3. Yellow Appticant J
CABC 0! 8IId 8 AY 110L[011t
ADDRESS ZONJNG c�« u��
5072 Pondsed e
LEGAL DESCRIPTION (office ust onJy)
LOT BLOCK 3 ADDITION deerfield 8th add. pID
�� R ' Karrie Logan (phone) g52-440-6360
(Address) 5072 Pondsedge
B �' D � Superior Exteriors MN Inc. 512-382-2549
(Company Name) (Phone)
(Contact Name) Steven E 1 ie �, 612 - 3 62 - 2 54 9
(Address) 4520 Tower St . Edina, NIDT 55424
TYPE OF WORK ❑ New Construction []Deck OPorch L�e-Roofing []ReSiding [ILower Levu Fnush ❑ Fireplace
[�Addirion []Alteration �Utility Connection
CODE: QI.R.C. �I.B.C. ❑ Misc:
Type of Conslruction: I II IIt IV V A B 15 , 0 0 0
Occ�pancy Grc�up: A B E F H I M B S U PROJECT COST/VALUE S
Division: 1 2 3 4 S (ea land)
2 6ereby certiPy diat I have furnished information on this applicatloa afiich is to the best oP my knowledge tnre and comd. I aiso ce�tit�r that I sm the ownu ar anthariae8 a�nt for the
abovcanentioned prc�perty and that aU constructi� wiU conPotm to all e�risting sWto and tocai laws aad witl proaed in acmrdaace with sobmitted plans. F am aware tAat the building
o@3aa1 ke this pecmit fa jnst� �, I� that the city o�cial or a design� may eater upon ffie property to ye�fomm �eeded inape�tiaas.
X ��� ' � ' ��� - BC 6 3 912 9 6 f 8/ 12
Signature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # S
Plan Check Fee $ Water Meter Size 5/8"; 1"; �
State Surcharge S Pressuxe Reducer $
Pena.ity $ Sewer/Water Connection Fee # $
Plambing Permit Fee $ Water Tower Fce # S
Mechanicat Permit Fee $ $uilder's Deposit S
Sewer 8c Water Pcrmit Fce $ Othu $
Gas Fireplace Peimit Fce � TOTAL DUE S .�'
T6is Appllcatfoa Becomea Yom $uildiug Pamlt When A@Pro� Paid Recei N
Datc B
Please call for
B "'� ; " °�`"� � Ple�.se mail permit to home owner 6123822549
This ia to catlPy dwt the requeat in du above application and aaompanying dornments is ia aceoo�dana wit6 the CSty laaing Oidinance and may proaefl as reqoated. This dacummt
whm signed by the Ciry Planner camsamt�s a temporary CerCficate a� Zoning compliance aad allowa consanction m�ce. Hefare oavpancp, a Certlfidte af Ocenpancy must be
issned.
P ' Director Date S iel Condiriona, if �y
24 hoar notice for ail iaspecttons (952) 447-�85@, faz (952) M7-4245
46q6 Dakota Street 3.E., PNor Lake, Minnea�ta 55372
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