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co pRr°� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
A. TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
v ii, AND UTILITY CONNECTION PERMIT .,. Z g' <S-
41,vs.s0's•
I.white Cit
2Pink City PERMIT NO. /5.� ri(;6,
.
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING once use)
2921 Fox Trail NW
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
INNER Steve and Josenda Lytle (Phone) 952-270-5896
time
(Address) 2921 Fox Trail NW Prior Lake, MN 55372
BUILDER Turnkey Restoration
(Name) (Phone) 612-405-8876
(Contact Name) Spencer Mistelske (Phone) 612-267-7310
(Address) 12767 73rd Ave N Maple Grove, MN 55369
TYPE OF WORK 0 New Construction ODeck ❑Porch [ORe-Roofing ❑Re-Siding
❑Lower Level Finish 0 Fireplace ❑Addition ❑Alteration ❑Utility Connection
0 Misc. PROJECT COST/VALUE (excluding land) $10,107.50
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 property 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 revoke this permit for just cause. Furthermore,I hereby agree that the city official or a designee may
enter upo j,.'e property to .. • .needed inspections.
i BC693119 '1.72--A5/1—(----
Signature Contractor's License No. Da
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; F'; $
State Surcharge $ Pressure Reducer $
Penalty $ City SAC and WAC # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Application Becomes Your Building Permit When Approved Paid 174i- /1r
' i(2-r
' 'pt No.
Date f- --9,/.(0-9
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.
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Planning Director Date Special Conditions,if any
24 hour notice for all inspections(952)447-9850,fax(952)447-4245
16200 Eagle Creek Avenue Prior Lake,MN 55372