HomeMy WebLinkAboutFence Permit 11-0006 �� " \�' CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
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� r; ` x TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
" �_�'�\ � `" AND UTILITY CONNECTION PERMIT
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1. White File pERMIT NO . /�
2. Pink City I�
3. Ycllow Applicant � �i �
(Please e or rint and si at bottom
ADDRESS ZONING (ott use)
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LEGAL DESCRIPTTON (office use only)
LOT BLOCK ADDITION PID
�aWNER � ��� OK-� �Q i�'v� '�=�-4��1 C�v�e (Phone) �� — �� � " � A 0 �
(Address) � � S �� �� ��$�S � ��
BUII,DER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Connection
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CODE: ❑I.R.C. ❑I.B.C. [�`�vlisc: �
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U PROJECT COST/VALUE �
Division: 1 2 3 4 5 (excluding land)
I hereby cettifg that I have furnished information on this application which is to the best of my knowledge crue and corred. I also certify that I am the owner or authorized agent for the
above-mention�d property an�H that all construction will conform to all e�cisring state and local laws and will proceed in accordance with submitted plans. I am awaze that the building
offiqia�can;ev�ke this pernu��or just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed 'nspec�ions.
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I
y - � S� re Contractor's License No. ate
Permit Valuarion 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 # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Applicario our Building Permit When Approved Pald ReCel t NO.
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Bui n Official Date
This is to certi that the request in the above applicarion and accompanying documents is in accordance with the Ciry Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner consritutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
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