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���% f PR I ��'� CITY OF PRIOR LAKE BUII.,DING PERMIT, � � Date Rec'd
�' /:; 1�' TEMPORARY CERTIFICATE OF ZONING COMPLIANC�
"��� �� ' `�' AND UTILITY CONNECTION PERMIT
, �
- �
l. White File pERMIT NO • �� �� /��
2. Pink Ciry
3. YeOow Applicant ^.J•./
ease or ' t and si at bottom
v ADDRESS ZONING (omce use)
7 S �..> .
LEGAL DESCR�TION (ofl['ice use only)
LOT BLOCK ADDITION PID
OWNER
(Name) (Phone)���. �� � '� � D
(Address) � � L- � �. c�
BUII,DER G,f
(Company Name) � C\� • (Phone) �S 1 � O `� � ��-�
(Contact Name) (Phone)
, (Address) � � b ` �
' TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing �Re-Siding OLowa Level Finish ❑ Fireplace
�Addition ❑Alteration ❑Utiliry Connection
^ CODE: I.B.C. ❑I.B.C. Misc•�
'l�pe of �instroction: I II III IV V A B �
Occapancy Gmup: A B E F H I M 8 S U PROJECT COST/VALUE $���'� �
Division: 1 2 3 4 5 (ezctodina land) �—
I hereby certify that I have furnished inf ' n on this application wirich is to the best of my knowledge true and wxrect. I also certify that I am the owner or anthorized agrnt for the
above-m ' ned property and that all co cdon will conforni to all e�cisting state and local laws and will proceed in accordana with submitted plans. I am aware dtaz the buildiag
official an ke this permit just cau . ore, I hereby agree that the city official or a desi ee nter upon the properry to p needed ias ectio
x ��OZ� I�� � ' O ' �
S e Contractor's License No. Date
Permit V ation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ 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 $ _ 7�'
This Applicadon B000ma Yo� Buitdins Pe�ic WLen Approved Paid ' Recei t o
Date B
Buildin Official Date
This is to certify that the request in the above applicaflon and a�mpanying documents is in accordana with the City Zoning Ordinance and may proceed as ceqaested. Thia document
when sig�ed by ttte City PL�nner constitutes a temporary Cerlificate of Zoning �mpliance and allows construction to commence. Before occupancy, a Certlficate of Oavpancy mnst be
issued.
Planning Director Date Special Conditions, if any
24 honr notice for rll inspections (932) 447-9850, fia (952) 447-4245
4646 Dalcota Strat S.E., Prior I,oke, Minneeotr 5Si72