HomeMy WebLinkAboutFence Permit 11-0048 (PR CITY OF PRIOR LAKE BU I. 1 • . ' RMIT, Date Rec'd
H, • TEMPORARY CERTIFICATE i ZONING C ) MPLIANCE
x AND UTILITY CONN - - 11 • • 9 MIT FO e.b
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A',A' N ESDCP I. White File PERMIT NO . /
2 Pink City /L 4-e
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
/ 4-2-S0 E '68//uD - /fi e
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID Z L33 % U O(, a
OWNER l ' t ^� � (��� �_ '� O�
(Name) V� Q� k-- \ 6 e `.'y� _. ( Phone ) 2 J a a ID- - LoU v 1
(Address) I id-,0 131 u•e.„b i (" \ 'L NJ P - L L '" ) 55711 J 1 -
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ['Deck EPorch ❑Re- Roofing ❑Re- Siding ELower Level Finish ❑ Fireplace �
['Addition ['Alteration ['Utility Connection � � O�
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CODE: I.R.C. ❑ ❑LB.C. D9 Misc. e C I L�NYG,
Type of Construction: I II III IV V A B / ` tieg 4HT f ftT L
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $
Division: 1 2 3 4 5
(excluding land)
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. 1 also certify that 1 am the owner or authorized agent for the
above - mentioned 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 revoke i is permit for ust cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X l b tel
• gnature Contractor's License No. 9 I 9
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 $
Gas Fireplace Permit Fee $ TOTAL DUE $
This Applic /it! J ' j comes Your Building Permit When Approved Paid ` T` Receipt - 7
Date By
_i I ng Official D< to
This is to cer fy 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
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This drawing is neither a legally recorded map nor a survey and is not Map Scale N
intended to be used as one. This drawing is a compilation of records,
information, and data located in various city, county, and state offices, and 1 inch = 38 feet
other sources affecting the area shown, and is to be used for reference W E rti •
purposes only. Scott County is not responsible for any inaccuracies herein Ma p date
contained. If discrepancies are found, please contact the Scott County ]
Surveyors Office. 9/9/2011 S y' cr