HomeMy WebLinkAboutFence Permit 05-0029
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City
Applicant
(Please type or print and si~n at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT I BLOCK
aoHtJsotJs /tDO^/
/ ADDITION
OWNER I' J
(Name) I' e.n
(Address) J55!i5
:D C,r?llS5jrt~
~w f.iMJe SE.
(Phone) CJ52. 22&. '-1250
7ki~ L~ie. I1Jf i;5372- LB2../
,
i BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration o Utility Connection
ORe-Siding
Date Rec' d
B. It;; -OS
PERMIT NO.
05.
27
ZONING (office use)
/eISO
PID 25. /52-. 00/.0
, 1
? F6A/~-
OLower Level Finish 0 Fireplace
Wit/Ie VINYL-
A"J./!:J Ch /li/V' t-I N /C..
CODE: ~.R.C. DI.B.C. 'f Mise
Type of onstruction: 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 certify that I have furnIshed Inf()rmation on this application which is to the best of my knowledge true and COlTect. I also cerufy that I am the owner or authollzed agent for the
above-mcnttoned property and that all construction will conform to all eXIsting statc and local laws and will procccd in accordance with submttted plans. I am aware that the building
~lICl~: ~hIS:I;I: ~)r Jl . cause pFllrthermore, I hereby agree that the CIty official or a deSignee may enter upon the property to pertc)rm n~e~;nZ~~~5
Signature c/ Contractor's License No. Date
Permit Valuation
Park Support Fee
SAC
Permit Fee
$
$
$
$
$
$
I $
I $
TOTAL DUE
Plan Check Fee
Water Meter Size 5/8"; 1";
Pressure Reducer
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
SewerlWater Connection Fee
Water Tower Fee
Builder's Deposit
Other
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
~~ Mt.- jY;;tolos
Bulldtllg OffiCial ' Date
Paid
Date
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#
$
$
$
$
I $
I
$
$
$
$
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#
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By r-
ThIS 1.'\ to (ertify that the request in the abuve applicatIOn and accompanYll1g documents is in accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Pl.1nnef constItutes a temporaty Certificate of Zonmg compliance and allows constructtcm to commence Before occupancy, it Certtficate tlf 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