HomeMy WebLinkAboutFence Permit 05-0039
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
lb. 1", C6
I White
Pink
Yellow
File
City
Applicant
\ PERMIT NO. Os: 3~
(Please type or print and si~n at bottom)
ADDRESS
/3/'Z& /c6J1Ifl#q '{l)N' ~G
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PlD25: 4--1..7, 6 /3; ~
OWNER 'J CJ
(Name) fo..'f~tV ;ci)SU
(Phone)
Q,52-- r'?'5- 3no
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAdditlOn OAlteration OUtility ConnectIon
ORe-Siding OLower Level Finish 0 Fireplace
CODE: OI.R.C. OI.B.C. P(M1SC.
Type of Constmction: 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
fs, I pjt!,/V~e.y Pe:;./a3'
PROJECT COST IV ALUE $
(excluding land)
[ hereby certity that 1 have hmllshed lOformatlOn on this applicatIOn which IS to the best of my knowledge true and correct. I also certify that I am the owner or authOrized agent tllr the
above-mentIOned property and that all constructIOn will conform to all eXIsting state and local laws and WIll proceed in accordance with submitted plans [am aware that the buildlOg
Ot1iC~.~-L._ I I"~' . Just cause Furthermore, I hereby agree that the City official or a deSignee may enter upon the proper1y to pertl)rm needed lOspectl<lns
X ~ ~_; _. . /O.-y'-pr
Signature Contractor's License No Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ Pressure Reducer $
Penalty $ SewerlWater Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $ ,/J ()
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ (!)t' q .
~
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Paid Receipt No.
Date By
I.
[h1'Ild1tl~ ~ .........
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ThiS IS to certify that the request m the above applicatIOn and accompanymg documents IS m accordance With the City Zoning Ordinance and may proceed as requested TIllS document
when signed by the City Planner constitutes a temporary Certificate of Zonmg compliance and allows construction to commence Before occupancy, a Certificate of Occupancy must be
isslIed
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
KENSINGTON AVENUE
CERTIFICATE OF SURV~Y
CUDDIGAN CUSTOM HOMES
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1CIEPM8 PlAN lET ON SITE AT AU. TIES.
Scale: 1't = 30t Page 2 of 2
For:
APPROVED
PLANNING DEPT
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91' Date It /27 (6 "I
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