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PRIG
� ° - - i t - CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
x
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
" ( `� AND UTILITY CONNECTION PERMIT
A
1. Pink City NO .-
2. Pink Citt y
3. 5 Q
3. Yellow Applicant 3 ' �!
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
2830 Fox Run NW
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER
(Name) John Japs & Sue DeLadi (Phone) 952- 215 -5675
(Address) 10335 Colorado Rd, Bloomington, MN 55438
BUILDER
(Company Name) Elite Exteriors, Inc. (Phone) 651 - 688 - 7808
(Contact Name) Jason Vogen (Phone) 651 - 470 -5038
(Address) 1513 Southcross Dr W, Suite A, Bumsville, MN 55306
TYPE OF WORK ❑ New Construction ['Deck ['Porch XJRe- Roofing DRe-Siding ['Lower Level Finish ❑ Fireplace
['Addition ['Alteration ['Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc:
Type of Construction: I II III IV V A B
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $ 29,000
Division: 1 2 3 4 5 (excluding land)
I here. .1;4 that I h. e furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the
e- mentioned �.y •� that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official c an revok '. r j cause. Furthermore, I hereby agree that the city o fficial or a designee may enter upon the property to perform needed inspe ons.
4 x �� /� BC509942 Exp 3' 7
f Signature Contractor's Li Date
Permit Valuation 1. Park Support 1 t $
Permit Fee $ SAC # $
Plan Check Fee $ Water Met, r 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 $ i q_ /15---
This • J " • • . n Becomes Your Building Permit When . pprove. Paid "7 l
d 4 r
Th Receipt No.6f 5.OJ
1 Date 11 1 (2_,"7„— 3 By , - �--
Bui ding • ' r . r, ate
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 Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372