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0 4 ° p R to� CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec' d
� �� TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
" AND UTILITY CONNECTION PERMIT s ' 2 �`�� —
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LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
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Siaaanm Co�trador'a Liea�se No. Datc
Permit V tion Puk Suppat Fee #� S
Permit Fee S SAC # S
Plan Check Fee S Water Meter Size 518"; 1"; S
Stau Surcharge S Pressure Reducer S
Penalty S Sewer/Water Connection Fee # S
Plumbing Pernrit Fee S Water Tower Fc�e # S
MechanicaI Permit Fee S Builder's Deposit S
Sewer d� Water Pamit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Applicatian Becomes Your Bnilding Permit When Approved Paid R ei 1�Io.
Date ,3 � 3 ..
Buildin Official Date
This is to certify that the request in the above applicadon and accompanying documents is in acrnrdance 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