HomeMy WebLinkAboutFence Permit 05-0036
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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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)
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LOT)If BLOCK ADDITION
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OWNER DTlj," D fI~yc-s
(N ame)
(Address) 71 i,c) I-L .:II,
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Date Rec' d
CJs- :3 ~
I PERMIT NO. ~'ft)~ I
ZONING (otTice use)
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(Phone) c;/ Z- - 3 (:7 'i - C'/.57
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BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
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: 1 2 3 4 5
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TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level FInish 0 Fireplace
OAddition OAlteration OUtility ConnectIOn
PROJECT COST /V ALUE $
(excluding land)
I hereby certify that I have furnished mformation 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
abllvc-mentJoned pelt)' and tha~tll c nstJuctlon WIll conform to all extstmg state and local laws and WIll ptOceed m accotdance WIth submItted plans I am awale that the bUlldmg
lltfiClal can re e thIS pClmlt ~ Just ca se FUlthelmore, I heteby agree that the City offiClal or a deSIgnee may enter upon the property to pel form needed mspectlOns
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, Signatu~ ~ Contractor's LICense No Date
Permit Valuation
Park Support Fee
SAC
Permit Fee
$
$
$
$
$
$
$
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---,
Building Permit en A
Paid
Date
Plan Check Fee
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Water Tower Fee
Builder's Deposit
Other
.....
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TOTAL DUE
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# $
# $
$ r
$( I
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Receipt No.
By
licatlOn and accompanymg documents is m accordance WIth the City Zoning Ordinance and may proceed as requested TIllS document
a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Ccrllficatc of Occupancy must be
Planning Director
Date
24 hour noticc for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any