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PR ID V
( 'Y OF PRIOR LAKE BUILDING PI
-141C a TEMPORARY CERTIFICATE OF ZONING COMPLIANCE Date Rec'd
r ,��. AND UTILITY CONNECTION PERMIT
Q J
N'NBSD v' / J
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ease . or and :�,ac bottom %v city PERMLfföT / ç -' - J
ADDRESS Applicata
.�i a"], & Uri S-Z- SE ZONING(�� e)
LEGAL DESCRIPTION(office use only)
LOT 1 BLOCK C ADDITION 9;// A S / /— /s_ / /] /
7-a;7,-
OWNER ,�" .'
(Name) IVIXiY i(VI, DG(Cb�/�/
____________________________]
(Address) rJZ7`'j Ou✓L (Phone)
S-E- SE-
BUILDER
EBUILDER
(Company Name) K1h 0 r Of aCe 11e n C
(Contact Name) ncl& Me-ndo2 L (Phone) _._.________________]
C�S��ZQ�7-diD�+-�
C10 �(7 -Tip (Phone)
(Address) �15
Lo� 22),L4 a aft,iYi N ‘. ,.3 1zz.
TYPE OF WORK 0 New Construction QDeck
DAddition DAlteration [Utility Conner [�Re'Siding ❑Lower Level Finish 0 Fireplace
on
CODE: ❑I.RC. ❑I.B.C.
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
PROJECT COST/VALUE $ 7
Division: 1 2 3 4 S 2._()(.42-z`'
(excluding land)
I hereby certify that I have furnished information on this application
Ioaboel tan onr tpropertyIhav and iall fo mattaron will � which is to the best of my knowledge true and correct. I also
UAL 1 eevoke this ft for just ll con ru Furthermore,will I existing to all state and local laws and wilt proceed in certify that I am the owner or autareiagent it in e
% / �; hereby agree that the city official or a designee may enter upon the property with
�plans. I e inspections.aware that the building
CTO
T. Perform needped r
Signature ; t� .fi'�i Q U,.!`'E-1"t
Contractor's License No.
Permit Valuation Daae
Permit Fee _ Park Support Fee #
lininMill
Plan Check Fee $
Pressure Reducer $
Sewer/Water Connection Fee # $
Plumbing Permit Fee 11.1111111111111
Matrical P Water Tower Fee # S
ermit Fee UIII_-
Sewer&Water Permit Fee Builder's Deposit $
Gas Fireplace Permit Fee IIIIIIIIIIIIIII Other $
TOTAL DUE s '
IMFThis Application Becomes Your Building `
ding Permit When Approved IraMI EINI
t'ate Rete't t No. RAW L�
B
Buildin_Official Date 1 \
This is to certify that the
when City request arrest in
the above
os a plication and accompanying documents is in accordance with the City
issued. porary Certificate of Zoning compliance and allows construction to Zoning ordinance ocd may proceed as requefOc Tail ydumere
commence. Before o�Panry,a Certifipte of Occupancy must be
Planning Director
24 hour
notice for all inspections(952)447-985 i fax 952)447-424 )al Conditions,if any
4646 Dakota Street S.E.,Prior Lake,Minnesota 55372