HomeMy WebLinkAboutFence 11-0024 i r PRi CITY OF PRIOR LAKE B IT, Date Rec'd
TEMPORARY CERTIFICATE \ F ZONING COMPLIANCE
. x AND UTILITY CONNED N PERMIT
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t/jN1YESO .C� I. White File PERMIT NO . _ /J
2 3 pink Cpl l / 7 L(�
3 Yellow Applicant (�/
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
\ (0310 iNcAckr\ Ave , 51-7. , Rites Lo k.e .
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER ' I I it _ -Q ,\ - Y ���( Phone) R5D 15 U -C ?L! J
(Address)
BUILDER
(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 ¢ /
l:{r/ /,� ,
CODE: ❑I.R.C. ❑ Yjilisc.
I.B.C. f i / �✓ l/���
Type of Construction: I II III IV V A B PROJECT COST /VALUE $
Occupancy Group: A B E F II I MR S U (excluding land)
Division: 1 2 3 4 5
1 hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that 1 am the owner or authorized agent for the
above-mention":. property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can revo' t - is per • it for bus a t(ltinlore, hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
I X (Q - 15 —II
lik— Signature Contractor'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 # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
0
Gas Fireplace Permit Fee $ TOTAL DUE $
This Applicati B s Your Buildng Permit When Approved Paid Receipt No.
Date By
Bu dine Official Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes 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 Prior Lake, MN 55372
Scott County, MN r
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This drawing a gall a o Map Scale N
intended to be is used neither as eon! This y recorded drawing is a com pilation survey of record is ns, t A
inform ation, a it, map county, is to be and state offces, and 1 inch = 19 feet
other sources affectand dating the located area in shown, various c an used reference vv 4,E
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purposes only. Scott County is not responsible for any inaccuracies for herein
contained. If discrepancies are found, please contact the Scott County Map Date i-- Y
surveyors Office. 6/9/2011 S (j