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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
AN1
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT 75
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1.white File
z. Pink city PERMIT NO. j n6[`2 I ,
3.Yellow Applicant ( V 7.`+'
• (Please type or print and sign at bottom)
ADDRESS ZONING(office use)
41
5734 Maves Trail SE. Prior Lake, MN 55372 r-kIS i\
LEGAL
LnDESCRIPTION(office use only)
LOT/6 BLOCK /ADDITION , ao 4 PID �- /,,
t.J'' �w 650
OWNER Mike/Pat Harvey (Phone) 952-226-5798
(Address)5734 Mayes Trail SE. Prior Lake, MN 55372
BUILDER Custom Remodelers, Inc. (651)784-2646
(Company Name) (Phone)
(Contact Name) Karli Anderson (Phone) (651)784-2646
(Address) 474 Apollo Drive. Lino Lakes, MN 55014
TYPE OF WORK ❑New Construction :Peck ['Porch ORe-Roofing ❑Re-Siding DLower Level Finish 0 Fireplace
DAddition ['Alteration ❑Utility Connection
( CODE: ❑I.R.C. ❑I.B.C. ❑Mi.: 10 Window Replacements
Type of Construction: I H lII IV V AB 17,952.00
( Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE $
Division: 1 2 3 4 5 (excluding land)
I hereby certify that I have ' ed info 'on 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-men'o ed property an that all cons ction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
ox cial�c yoke this for just c e. u ermor�eby agree that the city official or a designee may enter upon the property to perform needed inspections.
CR001748 June 11th 2015
ignature Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ . Water Meter Size 5/8"; 1"; $
State Surcharge $
014
�T c/�y Pressure Reducer $
Penalty $ ! f Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer&Water Permit Fee $ Other $ ` 7
Gas Fireplace Permit Fee $ TOTAL DUE $ lg
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•
This Application Becomes Your Building Permit When Approved 6)lid ilq :7< Receipt No. /(1
Date / c By
x . 1 5^. 1 2
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