HomeMy WebLinkAboutFence (pool) permit 08-0046
(Please type or print and siJP;n at bottom)
ADDRESS
S781
CITY OF PRIOR LAKE B DING~IT.
TEMPORARY CERTIFICATE F ZONING C9MPLIANCE
AND UTILITY CONNE .. ~Kt\1IT
I While
Pink
Yellow
File
City
Applicant
rV\J,'~~ /?tdqe e,f.
~,c .
LO~ 3 BLOCK I
LEGAL DESCRIPTION (office use only)
ADDITION
D~t@ R@~' d
PERMIT NO.
?Ef/cC
y-fl,
ZONING (omce use)
OCt.. (LY'" J 1-(: (1' - (~ 4J!PID ~~)() iJ0:13 0
L.K It"Jhe: I (Phone) q jL. LfY7-_S'a IS'
~ (f. S C i f (' I U ~ h c.k ,Jlt1/V -5 S-:3 l 2..
OWNER
(Name)
(;U'f'..Qo,,, f Ch('l.~+,'''e
S7 81 r,.., elf 4 ~ It 'Jltj e
(Address)
BUliDER d
(Company Name) (V\ i \IJ ~s +-
(Contact Name) ~ o~
(Address) .s-.J5"
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAdditlOn OAlteration DUtlhty Connection
>G1SC
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group:
Division:
A
ORe-Siding OLower Level Finish 0 Fireplace
Po 0 l.-. FE.-tJ~ - RetJ1Q,c..e. :Yi'Sf.,,~
PROJECT COST IV ALUE $ ~ 'J :l Cf . -
(excluding land) ·
-
1;:..
Pe. t"\, c.. c..
P~de(' $.),,)
Vi fI(i("1..tne.
S-t. p~ I
1'057 -- l.f CI - 2-1-2-,
(;,.5"/ - ~o 3 - S-, 09
S-S- 0 '7,s-
I hereby certilY t have hlrnlshed mformatllln on this application which IS to the best of my knowledge true and correct. I also certllY that I am the owner or authorIzed agent for the
above-mentllln pr perty and that all constructIOn WIll conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
~licial can rev kexr J'O r~rJ the CIty official or a designee may enter upon the propeny to perform needed '7:t:n~_u cg-
~ .....-'-. S~aturer -....) - Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
(Phone)
(Phone)
MAl
Au 4!.
B
I
E
u
II
F
I
III
H
2
IV
I
3
V
M
4
A
R
5
B
S
$
$
$
$
$
$
$
$
Park Support 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
Buildmg Ofticial
Paid
Date
Date
# $
# $
$
$
# $
# $
$
$ {If
$
Receipt No.
By
ThIS IS to certllY that the request m the above applicallon and accompanymg documents IS ll1 accordance wIth the City Zoning Ordinance and may proceed as requested. ThIS document
when signed by the City Planner Cllnstltute> a temporaty Certificate of Zonmg compliance and allows constructIOn to commence. Before occupancy. a Cerllficate of Occupancy must be
isslIed
Planning Director
Date
24 hour notice for all inspeetions (952) 447-9850. fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any