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F PRio CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
(aft \e TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Q to
4 4'NEsolP I. White File
2. Pink City PERMIT NO.1 14, 6 3
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
5 0 CO Li ?o nd Se doe Gene.. RI
LEGAL DESCRIPTION(office use only)
LOT t BLOCK 3 ADDITION r /h /4�)0 PID W5 ,2 q.9 -0,2D-O
O
(NaWNER) AfAS‘n �QIR 1 (Phone) O/ 4 /( ' '-' -310 )
(Address) (.J.%-le. )
BU LDER
(Company Name) _A-0, Q Z6 E.c.),N-7 (Phone) 1'%%