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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
T EMPORARY CERTIFICATE OF ZONING COMPLIANCE
W2-
AND UTILITY CONNECTION PERMIT 1
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1. While File PERMIT NO . l -
2. Peak City f( 7
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
2645 Cougar Path NW, Prior Lake, MN 55372
LEGAL DESCRIPTION (office use only) 2-cis LOT 013 BLOCK 002 ADDITION 4 f L_CLS )CIlJ��. -i PID 254040320
OWNER
(Name) Paul Beckman (Phone)
(Address) 2645 Cougar Path NW, Prior Lake, MN 55372
BUILDER
(Company Name) Hunerberg Construction Company (Phone) 763 -463 -5040
(Contact Name) Jeff Ophoven (Phone) 763 -463 -5040
(Address) 11102 86th Avenue North, Maple Grove, MN 55369
TYPE OF WORK ❑ New Construction ❑Deck ['Porch ❑Re- Roofing ,fRe- Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc:
Type of Construction: I II III 1V V A B G„ f,-
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $ -2 J) /
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have 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
above - mentioned ! operty and 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 can revok/ is permit st c Furthermote, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
x . 1 .. l .' V / 6 ao ,�, 4,3 C- 1)--)3
' ignature c ontractor's License No. Date
Permit Val ti n
Park Support Fee # $
Permit Fee $ . �// � r SAC # $
Plan Check Fee $ f ']` / Water Meter Size 5/8 "; 1"; $
State Surcharge $ 5. 00 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 $ '71' '2
This Application Becomes Your Building Permit When Ap roved r�l V Q� Recei e t No. i / I�' J
_ /, 6-4 �' � Date B _ 1
7uilding 0 E � Date
This is to certify that , - . quest in the above application and accompanying documents is in accordance with the City Zoning ty o mg 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