HomeMy WebLinkAboutZoning Permit (fence) 06-0039
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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ADDRESS
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LEGAL DESCRIPTION (office use only)
LOTZP--1rMCK \~DDITION
OWNER
(Name)
C /, v'. r <: J /~ ~
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
Date Rec' d
White
Pink
Yellow
I PERMITNO'b~_3~
File
City
Applicant
ZONING (office use)
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PID
;Zc:; -Q)J -/20-0
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(Phone)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration OUtility Connection
ORe-Siding OLower Level Finish 0 Fireplace
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CODE: DI.R.C. DI.B.c. o Misc,
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5
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PROJECT COST IV ALUE $
(excluding land)
I hereby certify that I have hIrnlshed mformatlOn on this application which is to the best of my knowledgc true and correct. I also certIfy that I am the owner or authOrIzed agent for the
above,mentlOned property and that all construction will conform to all extsl1ng state and local laws and will proceed in accordance with submitted plans, I am aware that the buildmg
~ficlal can revoke tlm pelmlt f r Just cause Fl~thell;r; aglee that the CIty offiCIal or a deSignee may enter upon the property to perform neede;:ect;'"3 _ &~
Signature /' Contractor's License No Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
1ltGas Fireplace Permit Fee. $ t
T , tio^-~m Bwldmg P'~ r;;,:-r;;~
B n!! Otticlal ,,4~tc I
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Park Support Fee
# $
# $
$
$
# $
$
$
$
$
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid
Date
Receipt No.
By
ThIS IS to certIfy that the request m the above applicatIOn and accompanymg documents is m accordance with the City Zoning Ordinance and may proceed as requested ThIS document
when signed by the City Planner eonsl1lutes a temporary Certificate of Zonlllg comphance and allows construction to commence Before occupancy. a CertIficate of Occupancy must be
issllcd
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any
COLORADO
STREET
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