HomeMy WebLinkAboutFence Permit 07-0003
Date Rec' d
il z !! 7
+--~I L,L
PERMIT NO. 07 - 3
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I White
Pink
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File
City
Applicant
(Please type or print and si~n at bottom)
ADDRESS
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~6J./ YoZH-r ROA-h
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
fA\,) L
/~-:J/4
(Address)
1>. V 0 .1:TA-
~/SH ?6JrNT IfdlTD 6' t=
ZONING (office use)
(Phone)
'i~~ -l/Bro-9?'/9h-
i BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
ORe-Siding OLower Level finIsh 0 Fireplace
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
DAdditlOn DAlteration DUl1ltty ConneCtlon ~
CODE: OClI.R.C. OI.B.C. Mise
Type of &nstruction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
~Yc-'E (NO
~E:- 6-)
/
PROJECT COST IV ALUE $
(excluding land)
I hereby certlly that I have hlrmshed mformation on this appl1catlon which IS to the best of my knowledge true and correct I also certIfy that I am the owner or authonze,! agent for the
.lhove-mentlOned property and that all nmstruction w1l1 COnl'llm to all eXlstmg state and local laws and Will proceed in accordance with submmed plans I am aware that the blllldmg
~liClal can ITV(~::S 15e I ermore, I her~y agree that the City official or a deSIgnee may enter upon the propeny to pert(lrm nee;;';7~k '1
Signature Contractor's License No. , Datf:
Permit Valuation
Permit Fee
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
Plan Check Fee
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
#
#
State Surcharge
Penalty
Plumbing Permit Fee
Mechamcal Permit Fee
Water Tower Fee
Builder's Deposit
Other
Sewer & Water Permit Fee
TOTAL DUE
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
Paid
Date
~~~
.L!lz/ {} 7
. {Date
IlLlIldlllg Uniclal
$ I
$ I
: /~
k\0n (~fJ
r- $ V\ I
$ I
Receipt No.
By
ThiS 1S to certlty that the request in the above applicatlon and accompanymg documents is 111 accordance with the City Zlming Ordinance and may proceed as requested Th1s documellt
when signed by the City Planner constItutes a temporary Certificate of ZonIng complIance and allows construction to commence Before OCCUPilllCY, a Ccrtlticatl' l)f Occupancy must be
i\slIcd
Planning Director
Date
24 hour notice for all inspections (952) 447-9R51l. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions. if any