HomeMy WebLinkAboutFence Permit 07-0033
CITY OF PRIOR LAKE B UIN&~RMIT,
TEMPORARY CERTIFICATE 0 ZONING COMPLIANCE
AND UTILITY CONNEC MIT
I While
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City
Applicant
(Please type or \lrint and sign at bottom)
ADDRESS
(j1G/5T
0; S'(/V
17&2.&
LEGAL DESCRlPTION (office use only)
LOT & BLOCK G ADDITION IvtHP(6 C'7L-t-:;A./ L AlD
Date Rec' d
8,f07
PERMIT NO. 0"/_ 33
ZONING (office use)
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OWNER
(Name)
p e 7-e,.z. A 5 u c; AtU
/7C:L;J C, G ~ IS 7 6Z'
(Address)
Le~v
/
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(Phone)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
r 5~~~;;~-~S;?y
TYPE OF WORK 0 New Construction ODeck OPorch o Re.Roofing ORe.Siding OLower Level Finish 0 Fireplace
OAdditlOn DAlteration o Utility ConnectIon
CODE: DI.R.C. DI.B.c. ~iSC F6NC:& -
Type of Construction: I II III IV V A B PROJECT COST IV ALUE $ 300(!),00
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 hlrmshed InformatIOn on this applica!lon WhICh IS to the best of my knowledge true amj correct I also certIfy that I am the owner or iluthollzed agent tur the
dbove.m' 'pI rly an alleonstIUC!lOn wJlI confiJrm to all eXIstIng state and local laws and Will proceed In accordance with subm1lted plans I am aware that the buildIng
~IrUil can Ievok us pel mil tor JUS ause a;;a;;:Iee thilt he CI~:; or a d:;;;;~:;;;on ;;:;~~ t~rm need;/;IO~ /" 7
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Signature Contractor's LIcense No. Date
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
Permit Valuation
Permit Fee
$
$
$
$
$
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
MechanIcal Permit Fee
$
i $
I $
Sewer & Water Permit Fee
Gas Fireplace PermIt Fee
This Application Becomes Your Building Permit When Approved
Paid
Date
lllllldlllg Urticlal
Dak
#
$
$
$
$
$
$
$
I
i $
I
_./
(jJ
/
#
#
#
i $
Receipt No.
By
ThIS IS to certify that the requL'st In the ablJvc applicatlnl1 Jnd accompanYll1g documents is In accordance with the City Zoning Ordinance and may proceed as requested ThiS document
when signed by the City Planner CtlI1Stltutcs a temporary Certificate of ZDl1mg comphancc and allo\\'s constructIon to commence Before occupancy, a CertIficate of Occupancy must be
j,"islIcd
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