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PRI '01.„ �4' vl 16CITY OF PRIOR LAKE BUILDING PERMIT, Cj
Date Rec'd
47/(1/41'1:0)\ \* CERTIFICATE OF ZONING COMPLIANCE
U ���,��TEMPORARY �^ /'`. ��r
AND UTILITY CONNECTION PERMIT 7 7
ryNEsO
t.white File
z. Pink city PERMIT NO. A___/, 6
3.Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
16951 Elm Ave. SW
LEGAL DESCRIPTION(office use only) J
LOT BLOCK ADDITION PID ;)( '3(-1 -L 7t -o
OWNER
(Name) Dallas Grekoff (Phone) 952-496-9060
(Address) same as site
BUILDER
(Company Name) Budget Exteriors (Phone) 952-887-1613
(Contact Name) Jaymi Lund (Phone)
(Address) 8017 Nicollet Ave. S, Bloomington, MN 55420
TYPE OF WORK 0 New Construction ODeck ['Porch ❑Re-Roofing ®Re-Siding ❑Lower Level Finish 0 Fireplace
['Addition ['Alteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. 0 Misc:
Type of Construction: I II III IV V A B
Occupancy Group: ABE F HI MR SU PROJECT COST/VALUE $ 21.986.00
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-mention, property and that all con . ...;, will .,,. „ to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can rev, .this permit foi just cans,. r, ,erm. , r,ereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X I Jj 0 BC006564 7/10/14
/ Signature Contractor's License No. Date ,
Permit Valuation Park Support Fee # $
Permit Fee $ /11t I SSAC # $
Plan Check Fee $ CO
Water Meter Size 5/8"; 1"; $
State Surcharge $ c r 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 < $ 79.75
This Application Becomes Your Building Permit When Approved P4v1tk 1_I ° IS
S Receipt No. /7/ op
Da .,7. i4. L. By
Building Official Date
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