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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT 1/2 7 /07
(Please
ADDRESS
1 White
rink
yellen....
I PERMIT NO. 07 - 0 to 751
File
City
Applicant
ZONING (office lIse)
P:t. .<;'E, P~/LJ/< t-;4I<E
,
LEGAL DESCRIPTION (office use only)
LOT 8' BLOCK 5 ADDITION
OWNER
(Name)
(Address)
BUILDER . '
(Company Name) \iT !fuMES, lAIC
,
(Contact Name) J6S1-j
(Address) '!3()(o r311/lE- S6
~d~
PID 25, 21 '{- 0 n-~
(Phone)
/:::Jr- /7/1-'" c:,v"""-'
(Phone) . I::....,~ ;- -- ~/o:)j
(Phone)
'.{rl
TYPE OF WORK 0 New Construction DDeck o Porch )(IRe-Roofing ~Re-Siding DLower Level finIsh 0 fireplace
DAddition DAlteration DUtility ConnectIOn
CODE: l!I.R.C. DI.B.C. o Misc.
Type of onstmction: I II III IV V A B PROJECT COST IV ALUE $ /0; tJOO
Occupancy Group: A B E F H I M R S U ,
Division: I 2 3 4 5 (excluding land)
I hereby certify that I have furnished mformatlon on this application which IS to the best of my knowledge true and COHect. I also certify that I am the owner or :luthoflzed agent for the
abllve-mentlllned property and that aU Clmstrllctilln Will contlJrm tll all eXISt 109 state and lllcallaws and will proceed in accordance with sllbmllted plans I am aware that the bUlldlOg
oflicial (an r 'voke tlus permIt f Just cause Furthermore, I hereby agree that the cay official or a deSignee may enter upon the propel1y to perform needed lI1SpectHlns
X _ ,~~_",,_: t- ,~..vf Be 205/1<6&5 7/Z7/07
, Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
--
,2-5""
Sewer & Water Permit Fee
Gas Fireplace Permtt Fee
This Application Becomes Your Building Permit When Approved
~~
7/'1---7 ~ 7
Date
llllildlllg Uftieial
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
,
Water Tower Fee # $
Builder's Deposit i $
Other $
TOT AL DUE $ 70.Do
I paid-iJ~~.~D
Date 1'/7/" 7
I f
\ ~~cei~o. 5'-1270
~I
ThiS IS to certify that the lcquest in the above application and accompanymg documents is 111 accordance with the City Zoning Ordinance and may pu)cred as requested ThiS document
when signed by the City Planner ClmStltutes a temporary CcrtitIcJte of Zlmmg compliance and allows construction to commence Before occupancy, a CertifIcate of Occupancy must he
issued
Planning Director
Special Conditions. if any
Date
24 hour notice for all inspections (952) 447-91150, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372