HomeMy WebLinkAboutFence Permit 08-0033
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
White
Pink
Yellow
File
Cily
Applicant
(Please type or print and si~n at bottom)
ADDRESS
/Lld!!>? :shIN-
~
Aie
LEGAL DESCRIPTION (office use onl~
'~5..3 5An;( fb/~
LOT BLOCK ADDITION
/i~ ,,//no
OWNER
(N ame)
~Wv Rodln/0
/Cfol!31 sJ?fM- ~ J1/c
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
TDWr1 'J- ~f1itr ,-kn ~
(Phone)
(Phone)
Date Rec' d
8.I.O?;
PERMIT NO.
0.8. {)o3~
ZONING (office use)
K-I
PID ;25,;2 /5, t)J../ /, ()
qS;1-(P01~f9~
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition OAlteration OUtility Connection
~F1cC
ORe-Siding OLower Level Finish
o Fireplilce
CODE: DI.R.C. DI.B.c. XMiSC.
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5
PROJECT COST IV ALUE $
(excluding land)
I hereby certity that I Il<lve hlrmshed mformallon on this application which is to the best of my knowledge true and correct I also certlty that I am the owner or authorized agent for the
JboVe-menlloned property and that all Cllnstruction Will conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
olfielal can revoke tlus pelmtt for Just cause FUlthelmOle. I heleby agree that the City official or a deSignee may enter upon the properly to pel form needed mspecllons
X /U-.t6~ ) f".t{.()f
l r$slgnature Contractor's License No ~ Dilte
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
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
~
Paid ----- I r/
Date Y- . ir, (j)(
, f
Buildlllg Orticial
Date
# $
# $
$
$
# $
# $
$
I $ rl
R~eTpW-
By /V . --
l
ThiS IS to certlty thilt the request m the above applicatton and accompanymg documents IS in accordance With the City Zoning Ordinance and may proceed as requested TillS document
when signed by the City Planner constttutes a temporaty Certificate of Zonmg compliance and allows eonstructton to commence. Before occupancy. a Certllkate "fOccupancy must be
isslled
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