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U,�,� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
., s50�� $79.75
I.
PiFile
PERMIT NO, a7 0
3.Yellow Applicant /�r
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
14105 Shore Lane NE. Prior Lake, MN 55372
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PIN
• OWNER Nate/Sarah Klapperich 952-297-7249
(Phone)
(Address) 14105 Shore Lane NE. Prior Lake, MN 55372
BUILDER Custom Remodelers, Inc.
(Company Name) (Phone) (651)784-2646
(Contact Name) (Phone)(651)784-2646
(Address) 474 Apollo Drive. Lino Lakes, MN 55014
TYPE OF WORK IONew Construction :Deck @Porch IRe-Roofing ORe-Siding ❑Lower Level Finish 0 Fireplace
['Addition ['Alteration ['Utility Connection
CODE: ❑I.R.c. ❑I.B.c. 1 Entry Door Replacement into existing opevi
❑✓Misc:
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $ 12,059.00
- Division: 1 2 3 4 5 (excluding land)
I hereby certify th I have fiunished'... tion on this application which is to the best of my knowledge true and correct. I also certillr that I am the owner or authorized agent for the
above-mentio... . ?cry and tha ..••• ction will conform to all existingstate and local laws and will
* official can ..,.'t fat', proceed in theeprope witho submitted plans. I amaware that the building
Z. Fu'.erm I hereby agree that the city official or a designee may enter upon Property to perform needed inspections.
xt // •
ti CR001748
March 26th 2015
AIignature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8";I"; $
State Surcharge $ 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 $
lei1 f R ' /
This Application Becomes Your Building Permit When Approved Paid lei No. /�ff
Date 4 .2-. I B
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
dwhen 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
issue
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