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Jd8;)Y
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE. .
AND UTILITY CONNECTION PERMIT
Date Ree'd
5.24-.07
I. Whil. fil.
2. Pi1lk Ci.y
3 Yellow A.pplan!
[PERMIT NO. 07.03(74-\
I \ ZONING ,_., \
\fff~~"'~~~~Yl TrQII ~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
(AddresS)
=:-Name) ~dN IiV"{i'r/ ?n(,fL,,--,.nQ(J
(Contact Name) 64-" (~
(Address) 6&tI/ jJ) emor /a/ . if. 7h 'Wttlr.:r
=~ 'Phn ~ do U e tle-bs+
(Phone)
(phone) uGI,t/?;9. if. 3X)
.
(phone)
6-5() 'it,;L
TYPE OF WORK O,New Construction ODed OPorch :gRe.Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition 'sA1teration OUtility Connection 0 Misc.
CODE: OI.R.C. OI.B.C.
Type of coustnu:tion:
Oc:cupancy Group: A B
Division:
I
E
n
F
1
IDIV
H I
2 3
V A B
M R S U
4 5
s S,Cd1:8.<eG
PROJECT COST IV ALUE
(exc:ludingland)
I hereby certify thaI I have furnished information on this application which is to the best of my knowled8e trUe and correct. I also certify \bat I am the own~"I' Of authoriz--d agent for the
above-menl1oned propertY and that aU constrUction will COlIform to aU existinl stale and local laws and will proceed in accordance with submitled plans. I am aware that the building
;"' t 7""".':t'''' .1'" ''''....'";"';~.9-:;;?.._w-5)~b~
Si~ ContraCtOr's Lic:enSe No. Date
Permit Valuation
Pencit Fee S
Plan Check Fee S
State Surcharge S
Penalty S
Plumbing Permit Fee S
Mechanical Permit Fee S
Sewer & Water Permit Fee S
Gas Fireplace Permit Fee S
This Application Becomes Your Bulldinl Permit When Approved
Buildinl!. Official
Dale
ThIS is to certify thallhc requeSI in Ihe above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requL'Stcd. This documenl
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows constrUction to commence. Befon: I3CCIIpancy. a CL'ftifu:a.tc of Occupancy must be
issued
Park Support Fee ## $
SAC ## S
Water Meter Size 5/8"; 1"; S
Pressure Reducer S
Sewer/Water Connection Fee ## S
Water Tower Fee ## S
Builder's Deposit S
Other S
TOTAL DUE S
PIanlIing Director
Date s~ Coaditions, if lilY
14 hour notice for I\llnspcctions (~2) 447-9850. fiX (~2) 447-4145
16200 Eagle Creek Avenue Prior Lake. MN 55372
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