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•s CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
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.c...., -).. TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
0 / , -. 4-,:: AND UTILITY CONNECTION PERMIT
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'YAP Es
2 P'1.7;k Cit PERMIT NO. / q 1
3 V:11,,,,, Aprilk.Aol I
(Please tymorprint and sign at bottom
ADDRESS , t ,....
1 i ZoNING
f I I 34 3 '/&. e-4--\ el - i-4 - / /v 1 1 i
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FEEGAL DESCRIPTION (olicc ust- onl
I LOT BLOCK ADDITION PID
1 OWNER
(Name) d • ,
L ,„,, /,.., ii.../1 /7 (Phone) 6 iz..
(Address) ra en C 45 q.A,Itr-e-
BUILDER k
(Company Name) eteet, Che lesl‘'e-a77 et ' ( p h „ 0 ieri:k API Z ZA,
(Contact Name) St-e ve- 0 (.0A/ (Phone)
(Address) ,1i? 7 0 € 4...Cf V 14 lee i e",,--,
TYPE OF WORK 0 New Construction [Peck OPorch Xe-Roofirig I:Re-Siding OLowct Level Finish 0 Fireplace
EjAildirion OAlteration 012014 Coat.ctio. n
CODE: EJT.R.C. flI.B.C. DM
Type of Construction: 1 II III nr N. A B ei
Occupancy Group: A B E F III MR S U PROJECT COST/VALUE $
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Division: 1 2 3 4 5 (excluding land) :1
t iirreity cerniy that I urrashed into:ma:tun on this rginbraintin which is to the best f my knowledge mu; and correct 1 alt.° certify that 1 ant the owner or authorized iiittlIt 1.17 117t:
above-mentioned prk and ti LE alt corsouction will contra-in to all casting ale and local laws and will proceed in accordance with 1 plans : am aware that the building
iifficial
an till) 5 pearat hir )1IV, iAll `" l'nufmnimitre i hefisby agree :hitt the city oflicnal in a iksignee may enkl ilpOil tilt: pioperty to pertirma needed inspecnons.
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Stgficindt Contractor's License No. ate
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Permit Valuation ' Park Support Fee # $ 1
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Permit Fee $ SAC # $
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Plan Check Fee S 'vVater Meter Size 5/8"; I": $
,
State Surcharge $ 1 Pressure Reducer S i
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Penalty $ Sewer/Water Connection Fee # S 1
i
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Plumbing Permit Fee S Water Tower Fee # S I
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Mechanical Permit Fee $ 1 Builder's Deposit $
Sewer Si Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE I $ 79 75
This Application Becomes Your Building Permit When Approved ii 75 ,, t. ler
Receipt No. ,' , co. / /
I Date V/a,
B'
Building Official
This ts to cettify that thc request in theabot e application and imtorripanying documents i5 in accordance ',kith he City Zoning Chilinance and may proceed as requested. This docurni.to
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when signed ly, she City Planner nstitutes a tempi C'ettili: ate ot Zoning compliance and allows construction to commence Rte occupancy, a Celt:tint:it of Occupancy IllUsl i7t
isatmel,
Piannine Dr ector Date :Special Conditions. dim!,
14 hour notice for all inspections 052) 447-9160. fax (9S2) 4471245
4646 Dakota Street S.F.. Prior 1 ate, Minnesota 55372