HomeMy WebLinkAboutFence Permit 05-0022
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
2.. ~~
~ ~otl.
~~~ ~~~
LA~e N\...l
Date Rec' d
7. / /. 05-
1 White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 5. 2 Z.
ZONING (office use)
IC/SO
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name) HAL ~ t't\~~\5f\
f\~~~\'l\S
(Address)
'to Qet\l
pm 2$ 4-04-. on. 0
(Phone)
~ S~ ~ 4C\ -~"'"t.o
E
N\~
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck o Porch ORe-Roofing
OAddition OAlteration OUtility Connection
CODE: ~I.R.C. DI.B.c. " Misc
Type of onstmction: 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
ORe-Siding OLower Level Finish 0 Fireplace
Lf I W/&V6I1r I~N
PROJECT COST /V ALUE $
(excluding land)
I hereby certifY that I have f\irUlslied mf(lImation on this application which IS to the best of my knowledge true and correct. I also certifY that I am the owner or authonzed agent for the
above-mentIOned property and that all construction will conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
"flicial can revoke thIS permIt for Just cause Furthermore, I hereby agree that the CIty official or a deSIgnee may enter upon the propelty to perform needed mspectlllns
~
x
~~ .. -...... ~ ~
Signature
.....~
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
~y~~
BuildllH! Oflieial
7!i,/oS
'Date
Contractor's License No,
Park Support Fee
SAC
# $
# $
$
$
# $
# $
$
$
$
Receipt No.
By
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid
Date
ThiS IS to certify that the requcst in the above applicatIOn and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner constitutes a temporary Certificate of Zonmg compliance and allows construCllon to commence Before occupancy, a CertIficate of Occupancy must be
l~rn.~
Planning Director
'1 ;" / oS-
L6te .
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372