HomeMy WebLinkAboutFence Permit 05-0042
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/o.r1.aS
1 White
Pink
Yellow
File
City
Applicant
I PERMIT NO. S.
4-2-
(Please type or print and si~ at bottom)
ADDRESS
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Tki C12 La life .jllr/-):5~~ot
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT Z. BLOCK I
ADDITION
V,4U; A1J{)N.
OWNER / /
(Name) rN j 0<,,. iltl
V
I Pczti:/
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."h. > +-t i~' V
PID25./II. aoz. 0
(" i ". /'_1,;" ,({, ",., /1'
1!:.!>:X/. '. ~ I Uo' -C~ ,v. CL II
(f/.!J?}ltitf-bb 6~ k
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration OUtility Connection
ORe-Siding OLower Level Finish
o Fireplace
CODE: DI.R.C. DI.B.c. j(MiSC
Type of Construction: 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
?6iJ~
PROJECT COST IV ALUE $
(excluding land)
I hereby certify tl I have hlrnished mfmmatIon on thIs application which IS to the best of my knowledge true and correct. I also certify that I am the owner m authoIJzed agent ItJf the
above,mentlOn' property and that all construction will confotm to all existmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
ottiClal can re .ok: this pelmlt for Just cause FmthelmOle, I hereby aglee that the CIty offiCial or a deSIgnee may enter upon the plopenv to pel form needed l~speCtI mS7 ~
X !+i , IL CL- '-v Ie /?/ C;'S-
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 $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $ ()
Mechanical Permit Fee $ Builder's Deposit $ NV~
Sewer & Water Permit Fee $ Other $ ~.
Gas Fireplace permr Fee $ TOTAL DUE $
Th'it" Paid Receipt No.
Date By
I Building Oftici,1I--
ThIS IS to certify that the request m the above applicatIOn and accompanying documents is m accordance with the City loning Ordinance and may proceed as requested Tim document
when signed by the City Planner constItutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Ccruticatc of Occupancy must be
isslIed
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
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rhlS drawing is neither a leqally recorded TTlilp nOt il
survey ilnd is not intended to be nsed as one This
drawing is a compilation of recorelS, illfonnation, and
data located in various city, county, ami state offices,
ancl other sources affecting the area shown, and is to be
used for re.ference~~~., flip' '. -~'f-. 'lll.f',l,J,inot
responsible for an WF ~ _ , ,- \\qiP.i If
discrepeancies are Un c r1t i1e'!3Ed t
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October 17,2005
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