HomeMy WebLinkAboutZoning Permit (fence) 10-7 o` pR � O � CITY OF PRIOR LAKE BUIL G PERMIT, Date Rec'd
� > TEMPORARY CERTIFICATE O OIVING COMPLIA
� � AND UTILITY CONNECTI IT
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� Wh� Fib pERMIT NO. �
2 Mnk City O � �
3. Yelbw Appliaat
lease or rint and si at bottom
ADDRESS ZONING (oR�a use)
3 l Z �s � c l�J' � U�
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID �� �� �^�
OWNER .
(Name) �i 1� � ' �U � � (Phone) _ 9J�a 'gZ�' .��SG
(Address) ��{ 3.Z S e V e �.� l�� f 2 a N .� 3 7 Z
BUILDER
(Name) � !.v ►� '� 2 (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Conswction ❑Deck ❑Porch �Re-Roofing QRe-Siding
�� a� �(� a � n l� i_ ❑Lower Level Finish ❑ Fireplace OAddi6oa �Alteration ❑Utility Connection
IR
Misc. e. v� � 2 PROJECT COSTNALUE (excluding lan� S
I hereby certify that I have fumished infortttation on this application which is to the best of my lmowledge tcue and rnrrect. I also certify+ that I azn the owner or
authorized agent for the above-mendoned property and that all construction will conform to all existing state and local laws and will procced in accordance with
submitted plans. I aware that the buil ' fficial can revoke this permit for just cause. Furthermore, I hereby agee that the city official or a designee may
enter upon the pr t perfQ needed ' ections.
X �-1�'
Signa Contractor's License No. Date
Pennit Valuation Park Support Fee # $
Permit Fee $ SAC # S
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
State Surcharge $ Pnessure Reducer $
Penalty S City SAC and WAC # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit S
Sewer & Water Permit Fee $ Other E
Gas Fireplace Permit Fee $ TOTAL DUE $
This Application Becomes Yow Buildieg Permit When Approved Paid ReCei t NO.
�� � > v � �� / I o Date B
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B ' ding Official Dau
This is to certify that the request in the above application and accompanying documents is in aaordance with the Ciry Zoning Ordinantt and may proceed as requested. This document
when sigaed by the City Plazma constitutes a temporary CeRiRcare of Zaning compliance and aitoavs eonmuction to rnmmence. Befa�e oceupaney, a Cectiticate of Occupsncy must be
issued.
Planning Director Date Special Conditions, if any
24 hour �atice foe sll inspections (952) 447-9850, �ax (�52) d47-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
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