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�°`� �°� 9 CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec' d
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE � f�7� ���' �
" `�' AND UTILITY CONNECTION PERMIT
�
r �'NES��
,. wn�� F� PERMIT NO. � Z—/ L(o I
2. rmt c�ty
� 3. Ydiow Appliunt
ease or and s' ai bottOm
ADDRESS ZONING (oq'ice use)
5 I.-!l S�'" ' ZG�YI C.�Y�i�P� �S�i
LEGAL DESCRIPTION {office use only)
LOT BLOCK ADDTTION PID'
�� ER � /J1,1/t, �,���l�.�' 1I�01/� (Phone) � 52 ' ��P' �g�D
(Address) � ��! �(`1 S � Y �2/ 1 (�/I'�il �'i S�
BiJII,DER �udgtt Exteriors
(Company N 8017 Nicollet Ave S. (Phone)
(Contact Naz B�oomington, MN 55420 (Phone)
PH: (952) 887-1613
(Address) F: (952) 887-1659
TYPE OF WORK p New Consavction �Deck []Pomh �Re-Roofing DRe-Siding QLowa Level Fini�h ❑ Finpiace
�Addii�on DAtteratian �Utility Connecdon
CODE: [rI,RC. : �I.B.Ci
,�_3 w�deW: r �� '
Type of Conatiacdon: I. II III N V A B "� /�'jQ� ., 1 s � -�- �_
Occapancy Groap: A B. E F H I M R S U OJECT�o �var.vE'� L�� $•
Division: ' 1._ 2 3 4 5 (eacl ' land)
I hercby oetity that I have fumished infarmation on flus application whic6 is m thc bcgt of my lmowled�e ave and mrccct. I also oatify Wac I am die owner or authoriud ageat tar the
above-�n�ned pnopaty a� t6at all oonsaucteon will confacm to all e�ristiag stare and local iaws and w�71 proc�ed in acn�dance wid► submined plans. I am aware that the building
offxial this pecmit for j isc. Furthermore, I hereby agee that t6e ciry of&cial or a desigiee may entu the property to perfocm needed inspections.
x
gC�'01?SL� � � � /�.
Sigaature Contracxrn's License No. Date
Permit Valuation Park Support Fee # $
Permit F� $ SAC # $
Plan Check Fee � Water Meter Size 5/8"; 1"; $
State Surchazge $ Pressure Reduoer $
Penalty a Sewer/WaterConnectionFee # $
Piumbing Permit Fee S Waoer Tower Fee # S
Mechanical Permit Fee � Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee � TOTAL DUE S . 7�'
This ApQlication Beoomes Your Ba�7diog Permit VVhen Apjlroved Paid Rece'
Date b L` B
_ _ ..
Buildin Official Date
� is to � C e request in the above application and accoml�S'�S documents is in acxordance with the Cicy Zoning Ordinance and may proceed as requested. 'ILis document
s� bY rtY Planner consrimtes a tempoTary CertiC�cate of Zoning campliance and allows consavaion to wmmenoe. Befare o�uPaz►cY. a Ceiti6cate of Oocupancy must be
issued.
p(anning pirectos Date Special Conditioos, if any
24 hour aodce for all inapeMioos (952) 447-9850, faz (9S2) 447-4245
4646 Dakota Street SE., Prior Lake, Minnesota 55372