HomeMy WebLinkAboutFence Permit 10-05 oF PR/�� CITY OF PRIOR LAKE BU ING P RMIT, Date Rec'd
TEMPORARY CERTIFICATE ZONIN OMPLIANCE �.� Z ���
�' �� � AND UTILITY CONN ERMIT
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M�'�'NES��P I Whne F�le
2 Pink �,� PERMIT NO. ,� ��
3 Yellow Applicant
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ADDRESS ZONING (ott'ice use)
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LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
(Name) S (Phone) �Z � v -- �
(Address)
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-S�ding ❑Lower Level Fm�sh ❑ F�replace
❑Addition ❑Alteration ❑Utility Connection � �
CODE: ❑I.R.C. ❑I.B.C. M�sc.
/N � �
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U PROJECT COST/VAL $
Division: 1 2 3 4 5 (excluding land)
I hereby cerufy that I have him�shed mformat�on on this applicatton which �s to the best of my knowledge true and correct. I also cerufy that I am the owner or authorized agent far the
I �bove-menuoned propetty and that all construchon will conform to all exisung state and local laws and will proceed m accordance wrth submitted plans I am aware that the buildmg
utficial can revoke this perm�t for 7ust cause Furthermore, I hereby agee that the c�ty official or a designee may enter upon the property to perform necded inspechons
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Signa[�re Conuactor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mecharucal Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permrt Fee $ TOTAL DiTE $
This Appli a n omes Your Building Perntit When Approved Paid Recei t No.
Date B
�. Z. /C�
w ina Ufticial D�te
This is t cernfy that the request m the above appl�cat�on and accompanymg documents �s in accordance w�th the CiTy Zoning Ordmance and may proceed as requcsted This document
when s� ed by the C�ry Planner consututes a temporary Certtficate of Zonmg wmpl�ance and allows construchon to commence. Before uccupancy, a Ccrt�ficate of Occupancy must be
Gsaued
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (9S2) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
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