HomeMy WebLinkAboutFence Permit 07-0017
CITY OF PRIOR LAKE BU
TEMPORARY CERTIFICATE 0
AND UTILITY CONNE
Date Rec 1 d
.J- S-3
(Please type or print and sie;n at bottom)
ADDRESS
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City
Applicant
5/4-_ 07
F6NeE;
I PERMIT NO. 01. 0/1
I -
ZONING (office use)
/7381 S l/AJrCAlj
e I (CJ!A..~ S W
K2SD
LEGAL DESCRIPTION (office use only)
I
LOT 4-- BLOCK .s- ADDITION
WOOD l/ I f::::- /lV1 EJ7)9 T6J-
PID 23 .23 () 02.- O. 0
OWNER
(Name)-----Ja/TH <.' BONNIE So De/c 6){J/..sI"
(Phone)
(Address)
i BUILDER
(Company Name)
(Contact Name)
(Phone)
(Phone)
(Address)
TYPE OF WORK 0 New Construction OOeck OPorch ORe.Roofing ORe.Siding OLower Level Finish 0 Fircplace
OAddition OAlteration o Utility ConnectIon
CODE: DI.R.C. DI.B.c. ~iSC ;;::11/ t1 ~ /3/ OF (;, ,
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 J have hlrmshed mllll'mation on this applicatIOn WhICh IS to the best of my knowledge true and COlTect I also certltY that J am the owner or autho!'tzed agent Illl'the
abow.mentlOned property and that all constructIOn wIll contlll'm to all eXlstmg state and local laws and will proceed m accordance with submItted plans I am aware tliat the blllldmg
()fticial can revoke thiS permIt for Just cause Furthermore, I hereoy agree that the city official or i1 deSignee may cnter upon the property to perform needed lIlSpcCtlllI1S
x
Signature
Contractor's License No.
Date
# $
# $
$
$
# $
# $
$
I $ /3
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I $
Receipt No.
By
Permit Valuation
Permit Fee
$
$
$
$
$
$
$
$
Park Support Fee
SAC
Plan Check Fee
Water Meter Size 5/8"; I";
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Pressure Reducer
Sewer/Water ConnectIOn Fee
Water Tower Fee
Builder's Deposit
Other
Gas Fireplace Permit Fee
TOTAL DUE
mes Your Building Permit When Approved
Paid
Date
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any