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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
~ C l~ -4 /!~ UTILITY CONNECTION PERMIT
~~)~ /p .11 !!al,1I -i1;,:. ~::;,,,.", I PERMIT NO.
nJ: 'if!: at bottom) fI{jj ~
3037 ffl1v/C /t40~ /CO
Date Rec' d
I( {-(II
7. /ofJ3 I
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
(Phone)
(Address)
i BUILDER
I (Company Name)
I
I (Contact Name)
I (Address) /~. 7 <:..
(Phone) 1 S2 - f)'~-~O/S-
(Phone)
TYPE OF WORK 0 New Construction
OAddition o Alteration
ORe-Siding OLower Level finish 0 Fireplace
CODE: OI.R.C. OI.B.C.
Type of Constmction:
Occupancy Group: A B
Division:
o Mise.
B
S
A
R
5
IV V
I M
3 4
III
H
2
II
F
I
I
E
U
PROJECT COST IV ALUE
(excluding land)
$
ich IS to the best of my knowledge trlle and correct. I also certify that I am the owner or authorized ilgen! for the
n WIll conform to 1 existmg state and local laws and will proceed m accurdance wIth submItted plans I am aware that the buildmg
gree that the Clty official or a deSignee may enter upon the propel1y to perform needed mspcctlol1s
Contractor's License No.
Park Support Fee
SAC
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
Water Meter SizeS/8";l",
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
BlIildJ1l~ Uniclal
Date
#
#
#
#
1'-Q-rr-07
Date
$
$
$
$
$
$
$
$
$
ThiS IS to certify that the request In the abuve application and accompanymg documents IS in accordance with the City Zoning Ordinance and may pnKl'cd ilS requested Thls dlKUIDcnt
v,'hcn signed by the City Planner Clll1stltlltCS a temporary Ccrtitkate of Zomng compliance and allows construction to commence Bdnfc Dccupancy, ,1 Certlticate of Occupancy must he
isslIcd
Special Conditions. if any
Planning Director
Date
24 hOllr notice for all inspections (9:;2) 447-98:;0, fax (9:;2) 447-424:;
4646 Dakota Street Prior Lake, MN 55372