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o � rRt CITY OF PRIOR LAKE B�JTI.DING PERMIT, Date Rec'd
,� ,� TEMPORAIZY CERTIRICATE OF ZQNING COMPLIAI�ICE
„ � AND UTILITY CONNECi'ION PERMIT �
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Penriit Vataatian Park Supportt Fee # S
Permit R� " ' S SAC # S
PISn t�xck Fee $ � Wat�er Meter Sia� 5/8";1"; S
State Sor�charge $ Prrssure itednoer S
Penalty $ SewerlWater Connection Fee # � S
Plumbing Ptrmit Fee " S Water Twver P'ee # S
Mechatucal Pezmit Fce S- Buiider's Deposit �
s�r� wac��u �� s o� s
Gas Fir�place Peimit Fee S TOTAL bUE $'
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Date /1�— B
sup ott�ia� Date �
Tins is w axiil�+ thatt the request ia tbe abwe appaicatpa and a000arpa�iog do�tm�nts is at acao�danee wilb Urc C"� Zmti� Or+�aoeai�d may p�oceed at nql�soo�. 3]qs datnmest
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