HomeMy WebLinkAboutFence Permit 07-0029
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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Yellow Applicant
(Please type or print and siR11 at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT'j,~BLOCK
ADDITION /(.. J.;, ,A.-!-",^") v '," ~-c._)
OWNER
(Name)
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(Phone)
(Address)
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BUILDER
(Company Name)
(Contact Name)
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(Phone)
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TYPE OF WORK 0 New Construction ODeck o Porch o Re.Roofing
DAddition OAlteration DUtility Connection
Date Rec' d
PERMIT NO. 01, ooz-q I
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ZONING (office use)
PID
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ORe-Siding OLower Level Finish
CODE: OJ.R.C. OI.B.C. }z(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
PROJECT COST /V ALUE $
(excluding land)
I hereby certifY that I have furnished mf(,rmatlOn on this application which IS to the best of my knowledge true and correct. I also certifY that I am the owner or authonzed agent for the
abtive,meriilOned property and tha all conftruction will conform to all existIng state and local laws and will proceed in accordance with submitted plans, 1 am aware that the buildIng
otlicKlI can revoke thiS perm, "It fo, )\ st,Cal~S ,Fur ' e, I hereby agree that the CIty otlicial or a deSignee may enter upon the propelty to perform needed mspeel1ons,
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j Signature
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Permit Valuation
Contractor's License No,
Park Support Fee
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
SAC
Water Meter
Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
Buildll1~ Otlicial
Date
#
#
#
#
Receipt No.
By
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"1 91 V ~j:'S
o Fireplace
Date
$
$
$
$
$
$
$
$
$
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ThIS IS to certifY that the request in the above apphcal10n 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 Zoning compliance and allows construction to commence, Before occupancy, a Certificate of Occupancy must be
issued
+ Ii: /
lDate i
24 hour notice for all inspections (952) 447-9850, fax (952) 447.4245
4646 Dakota Street Prior Lake, MN 55372
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... '''----' Planning Director
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Special.coooitiollS; if any