HomeMy WebLinkAboutFence Permit 05-0013
(Please type or print and sign at bottom)
ADDRESS
5037-
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/ --J -
(0. l~ 06
I White
Pink
Yellow
File
CIty
Applicant
PERMIT NO. OS.
13
PO /J os t:..-LJ ~
L-N ,-) 6
ZONING (office use)
/2/
LEGAL DESCRIPTION (office use only)
LOT S BLOCK 2- ADDITION
OWNER C .
(Name) ~ ( tlt-+
(Address)
BUILDER
(Company Name)
(Contact Name)
I (Address)
.iJe&/Z,C; E.~W
a~
PID 2-5. .;:] qq (J I h, 0
4
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(9s-)) ~;)6 ,-6
l
9f?V
,
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j V I j (lV"l t...
(Phone)
(Phone)
(Phone)
ORe-Siding OLower Level Finish 0 Fireplace
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration OUtility ConnectIon
CIf/j / IV L- / AI/~ F6N'C-t::,:
CODE: ~.R.C. DI.B.c. ~MISC.
f
Type of onstnIction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5
PROJECT COST IV ALUE $
(excluding land)
I hereby certily that I have nlrnlshed mformatlon on this applicatIon which IS to the best of my knowledge true and correct I also eertIfy that I am the owner or authorized agent [llf the
above-mentIOned plOpelty and that all constluctlon will conform tLJ all eXlstmg state and local laws and Will ploceed m accOIdance WIth submItted plans I am <twale that the buildmg
OfflCI=f1 ca :vo~ e this jlel mlt ~~r JU~U1thclmOlc. I ht\'by aglee that the City oftiClal or a deSignee may enter upon the plOpeny to pel form needed m,spectl~ons .___
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Signature Contractor's License No Coat
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
Park Support Fee
SAC
# $
# $
$
$
# $
# $
$
$ A/
p
$ l
/
i
Reccmt No.
By
Water Meter Size 5/8"; I",
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOT AL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
BuildllW Otliclal
Date
ThIS 15 to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when si cd by the City Planner constitutes a temporary Certificate of Zoning compliance and allllws construction to commence Before occopancy. a Certificate of Occupancy must be
.PI'""~ c./7;:~-: ~ ~ Y~:<4
24 hour notice for all inspections (952) 447-9850, fax (952) 447-424~ A" _ --II {e J_ - ~
16200 Eagle Creek Avenue Prior Lake, MN 55372 r~ "'Ve .4,
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