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f,l pR,rO,P CITY OF PRIOR LAKE BUILDING PERMIT,
Date Recd
./\ �, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
1 e ; " g AND UTILITY CONNECTION PERMIT
"riNNESOlP I. White File PERMIT NO. 7
2. Fink App I /O• D O¢/ I
r. Yellow Applicant /
(Please type or print and sign at bottom) ZONING(office use)
ADDRESS
" `"5"-6S- ._S -;-C'co \ €-)U ..._
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
OWNER � ie � —
(Name) � l`�V `C� ��t,ion
S- . . •)•••.1 <
(Address) l,.......
BUILDER ��� (Phone) CUU ( `�
(Name) 0 (` c Q Th Co -� `� �►(3S—‘6) I."
(Phone) 40
(Contact Name) `► t. k.
(Address) c ci 0 �, - • 0 `IS'
TYPE OF WORK IN N- . •• •• '•n ❑
Deck ['Porch ❑Re-Roofing ❑Re-Siding
Addition ❑
Alteration ['Utility Connection
OLower Level Finish 0 Firepl�ice ❑ ��0 '
i P '/ROJ,fr ,T COST/VALUE (excluding land) $
4110Iisc. `,: y� .f AI! 14 i7 //I. -
•
an• • . construction will conform to all existing state and local laws and will proceed in accordance with
•
I hereb ertify that I have furnished information on this applic. which is to the best of my knowledge true and correct. I also certify that I am owner or
authorize • s ..oeementionedproperty
submitted.plans. I am aware . - a;,can revoke this •-rmit for just cause. Furthermore,I hereby agree that the city official or a dettgnee may
ente •.n the p operty to perform needed inspectio
g (�� / AL All•l
, -�r
Signature Contractors License Na Date
IIIIIIIIIIIIIII
,,/ Park Support Fee #
'ermit Valuation . $
Permit Fee $ 011.1111111.11111111111111
_
Plan Check Fee 10111111111111111 liill11111111111111
IEUIMIIIIIIIMIIIIIIIIIIIIII Pressure Reducer
11.11111111111
Penalty IIIIIIIIIIIIII
City SAC and WAC #
Water Tower Fee #
Plumbing Permit Fee 111111111111111111
1111111111111111
■ Builder's Deposit
Mechanical Permit Fee �INNIIII1111111111111111111
Other
Sewer&Water Permit Fee IIIIINIIIIIIII
TOTAL DUE
Gas Fireplace Permit Fee 111111111"11 0 MEW —
��cei•t No.
This Application Becomes Your Building Permit When Approved Paid Date / 0 .11111111111
E��
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. Tp p p his document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occu ancy,a Certificate of Occu atcY must be
issued.
Planning Director
Date Special Conditions,if any
24 hour notice for all inspections(952p447T 85 ,faxake01`�IN (952)447-4245
16200 Eagle Creek Avenue Pr