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CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT 79 75rE
1.White File
2. PPERMIT NO. i NN
Pink city / /J /1
3.Yellow Applicant / �i a'r] f
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
4341 Coachman Lane NE. Prior Lake, MN 55372 A
LEGAL DESCRIPTION(office use only)
•
• LOT q BLOCK ADDITION(?1le / t lG s- / AA/) 1 PID 0, j/ 8; 40 '2-e)
OWNER Loren/Marlis Davis (Phone) (952)440-8209 .
(Address)4341 Coachman Lane NE. Prior Lake, MN 55372
BU
ILDER
ER ) Custom Remodelers, Inc. (Phone) (651)784-2646
Comp anName
(Contact Name) Karli Anderson (Phone) (651)784-2646
(Address) 474 Apollo Drive. Lino Lakes, MN 55014
TYPE OF WORK 0 New Construction ❑Deck ['Porch ❑Re-Roofing DRe-siding ['Lower Level Finish 0 Fireplace
['Addition ['Alteration ❑Utility Connection
CODE: ❑I.R.c. DI.B.C. OMisc: 2 Windows and 1 Patio Door replacement.
Type of Construction: I II III IV V A B 6675.00
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ '
Division: 1 2 3 4 5 (excluding land)
4
I hereby ify that I ; - ..'shed information on..'-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-min oned pro . ,that all con .. 'on , conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official c revoke ..�'. just us., ermo e,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
x '( CR001748 05-28-2014
III
Sia.. Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ 7 i L 7 SAC # $ ----
Plan Check Fee $ , Water Meter Size 5/8"; 1"; $
State Surcharge $ `' C77)
Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
f
Plumbing Permit Fee $ 4/1 r / Water Tower Fee # $
Mechanical Permit Fee $ I Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ f/C 1 2'S
This Application Becomes Your Building Permit When Approved ' 'J Receipt No. -7/1,s 'I
te.).
a '2 'te 2rr ' By J
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