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( Rta. CITY OF PRIOR LAKE BUILDING PERMIT, Date Reed
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /. ( 9- q
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a c AND UTILITY CONNECTION PERMIT l
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A `'NNaso .. 2 '., rep y t fPERMIT NO.
3 Yellow Applicant
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(Please type or print and sign at bottom)
ADDRESS / ZONING (office use)
. /1S f 4 ( li Ape_ fecv e ‘• LEGAL DESCRIPTION (office use only)
LOT 2 BLOCK 6 ADDITION 5 4inc:e 0 , 3 cr� PID
OWNBR / � �,r
(Name) 7k VcoS (Phone) 4'/ , r Q "53
(Address) /5C,1 (t ea, ev,3 . i,, � ;41's v,Cl � / //// -
BUILDER
(Company Name) (/- (Phone)
(Contact Name) _ (Phone)
(Address)
TYPE OF WORK Q New Construction IiiiDeck (]Porch ORe- Roofing QReSiding (]Lower Level Finish 0 Fireplace
(]Addition ❑Alteration QUtiiity Connection
CODE: DI.R.C. DLB.C. 0 Misc.
Type of Construction: 1 II III IV V A B PROJECT COST /VALUE $ /04 D
Occupancy Group: A B E F /I I M R 8 U
Division: -. 1 2 3 4 5 (excluding land) •
1 hereby certify that 1 have furnished information on this application which is to the best of my knowledge hue and cornet. I also certify that 1 am the owner or authorized agent for the
above - mentioned property and that all construction will conform to all existing state and local laws and will plumed in accordance with submitted plans. 1 am aware that the Minding
official can •. ■ • , . i ii for just cause. Furthermorc.l hereby agree that the city official or a designee may enter upon the properly b ref m needed " • ns.
' �/.�-�ir G ..e///
• . ' Signature Contractor's License No. Date
' Permit Valuation i r 50 a co Park Support Fee # $
Permit Fee $ S ISO SAC # $
Plan Check Fee $ 31. Water Meter Size 5/8"; 1" ; $
State Surcharge $ r 75` Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee - $ Water Tower Fee # $
Mechanical Permit Fee $ - Builder's Deposit $
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Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ 16. 43 -
/ '/
Thl ' , , s ourBufdingPermlt When Approved Paid u E.e eL't No. f ��lr�
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13 c 7; e
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 construction to commence. Before occupancy. a Certificate of Occupancy must be
issued.
Planning Dkector - Date Special Conditions. if any
24 hour notice for all inspections (952)447-9850, fax (952) 447 -4245
4646 Dakota Street Pryor Lake, MN 55372
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SURVEYOR'S CERTIFICATE BRANCALE CONSTRUCTION, INC. -,, \;sui
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. \I N83 4°mE 00 �� $ - 17A9
24.50 ti t Iti
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•— — N 85° 34'06"E 138.34 4 N A o
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- mot-- -- DENOTES PROPOSED SURFACE DRAINAGE
O DENOTES IRON MONUMENT SET -SCALE: 1 INCH = q>3o FEET
• DENOTES IRON MONUMENT FOUND PROPOSED GARAGE FLOOR FEET
X000.0 DENOTES EXISTING ELEVATION PROPOSED LOWEST FLOOR z 9 FEET
(000.0) DENOTES PROPOSED ELEVATION PROPOSED TOP OF BLOCK = 9 FEET
I HEREBY CERTIFY TO BRANCALE CONSTRUCTION, INC. THAT THIS IS A TRUE AND CORRECT
REPRESENTATION OF A SURVEY OF THE BOUNDARIES OF:
Lot 2, Block 6, SAND POINTE 3RD ADDITION, according to the recorded plat -
thereof, Scott County, Minnesota.
AND OF THE LOCATION OF A PROPOSED BUILDING. IT DOES NOT PURPORT TO SHOW IMPROVEMENTS
OR ENCROACHMENTS, IF ANY, THEREON. AS SURVEYED BY ME, OR UNDER MY DIRECT SUPERVISION,
THIS 3RD DAY OF APRIL , 1984.
SIGNED: R. HILL, INC.
• 0/(1/46de--' „e/6-4;2../
BY:
HAROLD C. PETERSON, LAND SURVEYOR -
MINNESOTA LICENSE NO. 12294
PROJECT NO. BOOK / PAGE . • JAMES R. HILL, INC.
84602 t.
- Planners / Engineers / Surveyors
FILE No. 8g00 Humboldt Av•nu. South •
'FOLDER Blootrington, Mn. 55431 512 -884 -302a
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