HomeMy WebLinkAboutFence Permit 11-0004 oF rR� CITY OF PRIOR LAKE B RMIT, Date Rec'd
,, � TEMPORARY CERTIFICATE F ZONING C MPLIANCE !� -� ��
� y AND UTILITY CONNEC , MIT
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MI I N'hite File pERMIT NO . //_ /J�
_ rink cicy �
; l'dlo�c Applicant [ i
(Please e or rint and si n at bottom)
ADDRESS Z 1�TI0 NG �,>���� ��st�
��qZ W l LC�C�V✓ l3�ftC�f %7�/L�
LEGAL DESCRIPTION (ofl�ice use only)
LOT BLOCK ADDITION PID
OWNER �/� A / �/ � � (Phone) Q��-/-�/�
/v
(Address)
i BUILDER
(Company Name) (Phone)
� (Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finisll ❑ Fireplace
❑Addit�on ❑Alteration ❑Utility Connechon
�Mis'c. — ��/�,! l�C% _�—.
CODE: ❑LR.C. ❑LB.C. — -
Type of Constniction: I II III IV V A B pROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U I
(excluding land)
� Division: 1 2 3 4 5 ,
I hcrcby ccrtify that I havc Hirnlshcd mformation un this applicatiun which is tu the hcst uf my knuwlcdgc truc and cnrrcct. 1 �Iso ccruty that I am thc owncr or authunud agcnt ti�r thc
� ab��vc-mcnuoned pru crty and that all cunstructiun will cunti�rm tu all cxisung statc and local laws anA will procccd in accurdancc with suhmittcd plans I am awarc that thc buildmg
' uf7icial can revuke u permu fiu�usc cause 'urthermore, 1 hereby agree that the city ufficial ur a designec may enter upon the property h� perfi�rm necdcd mspcct�uns
c
X / / --
�gnature Contractor's License No. Da e
Permit Valuation Park Suppart 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 # $
Mechanlcal Permit Fee $ Builder's Deposit i$
Sewer & Water Permit Fee �$ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Application Becomes Your Building Permit When Approved Pald ReC�i t NO.
Date 7 B
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� F3uildina l)f�icinl atc
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This is io certify that thc requcst in the abu��e applicauon and accumpnnying documents is in accordance with the City Zuning Ordinance anA may prucecd as requcsted Th�s ducument
when signrd by the City Planner cunsututes a tempui.lry Certificate uf Zoning cumpliance and aLluws cunstrucnon to cummence. Befure uccupancy, a Cernficate uf Occupancy must be
i issui•d
Planning Director Date Special Conditions, if any
24 hoin� noticc for all inspcctions (9�2) a�17')850, f�x (9�2) -t�7-�3�35
4646 Dakota Street Prior Lake, MN 55372
BuILDING PERMIT SURVEY PREPARED FOR: V�Y y��� �.� P��
DIANE UTTLE 16670 FRANKLIN TRAIL SE
3592 `� W,l.L�.OW:: �3�A�`i�' TRA I L S W SUITE 230
PRIOR LAKE. MN 55372 PRIOR LAKE� MN 55372
(952) 447-2570
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