HomeMy WebLinkAboutFence Permit 05-0046
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
II. B.oS-
1 White
Pink
Yellow
Flle
City
Applicant
PERMIT NO.
05. 4iP
(Please type or print and sign at bottom)
ADDRESS
L/585 Pt-CAS/I;Vj S7~6/
ZONING (office use)
/<2-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 25.0 OZ. 03/.0
OWNE~ L 1'\
(Name)G-fJ.r.J I.JGhr..efll..-
(Phone)
qt;1: 'fL{) ''1'01.,0
- -
I (Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection
CODE: DI.R.C. DI.B.C. ftMiSC. FE/I/~ (p t' ~/ZIV~t!A/
Type of Construction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certIfy that I have h,rnished mformation on this applicatIOn which IS to the best of my knowledgc true and correct I also certify that I am the owner or autho!lzed agent for the
Jbovc-mcntlOncd property and that all constructIon WIll conform to all eXlstmg state and local laws and will proceed in accordance with submittcd plans. I am aware that the buildmg
official can revoke thIS pel orlust cause Furthermore, I hereby agree that the CIty official or a dcslgnee may enter upon the propeny to perform needed mspectlOns
xC/l~/ !1-1-0~
Contractor's License No. Date
Sewer/Water Connection Fee
#
#
$
$
$
$
$
$
$ rf() /
$ \I - /JA V
$ ~fl;r,- ·
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
Park Support Fee
SAC
#
#
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Water Meter Size 5/8"; I";
Pressure Reducer
Water Tower Fee
Sewer & Water Permit Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
~ ~ 1/,/1/oS
l:3urldlll~ Ottlclal Date
Paid Receipt No.
Date By
~~~
ThiS IS to certIfy that the request In the above applicallon and accompanymg documents is In accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner constItutes a temporary Certificate of Zonmg compl1ance and allows construction to commence. Before occupancy, a CertIficate of Occupancy must be
i.ssLlcd
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
Scott COllnty
Page 1 of 1
This drawing is neither a legally recorded map nor a
survey and is not intended to be used as one. 1his
drawing is a compilation of records, information, and
data located in various city, county, and state offices,
and other sources affecting the area shown, and is to be
used for reference purposes only. Scott County ;s not
responsible for any inaccuracies herein contained. If
discrepeancies are found, please contact the Smtt
County Surveyors Office.
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November 7, 2005
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