HomeMy WebLinkAboutFence Permit 05-0028
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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City
Applicant
PERMIT NO. 05'. Z-f?
(Please type or print and si~ at bottom)
ADDRESS
y. /1 tJ J-h 1 vI< ()A/77J
ZONING (office use)
/11/6
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LEGAL DESCRIPTION (office use only)
LOT t:'BLOCK I
I
ADDITION
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PID
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OWNER
(Name)
:JO{rJJ
(Phone) 75'2- - J- U - 576 2.
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration OUtility Connection ~Misc.
CODE: Ktl.R.C. DI.B.c.
Type of ~stnlction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
ORe-Siding OLower Level Finish
(,C-~. J?
PROJECT COST IV ALUE $
(excluding land)
o Fireplace
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and COlTect. I also cerufy that I am the owner or authorIzed agent for the
above-mentlOned plOpel ty and that all const! ucUon will confo~~~ eXistIng state and local laws and will plOceed In accordance wIth submitted plans I am aware that the blllldIng
otTIClal can revoke thIS PrJor Just cause FlllthelmOle, I he~ c.e that the City otTIClal or a deSIgnee may enter upon the property to perform needed InspectIOns
X ij ~';"a:e y (1~ Contractor's License No Date
'I
pplication Becomes Your Building Permit When Approved
t' ~ f/s-Io~
Building OtliciaJ" I Date'
Paid
Date
# $ I
# $ 1
$ ~ 'CY'Jc 1
$
# $
# $
$ 1
$ 1
$ 1
Receiot No.
By
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
I Penalty $
I \
I
I Plumbing Permit Fee $
I Mechanical Permit Fee $
I Sewer & Water Permit Fee $
l Gas Fireplace Permit Fee $
Park Support Fee
SAC
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
ThiS IS to certify that the request in the above application and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested TIllS document
when signed by the City Planner consl1tutcs a temporary Certificate of ZOl11ng compliance and allows construction to commence. Before occupancy, a Ccrtlficatc of Occupancy must be
issued
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