HomeMy WebLinkAboutFence Permit 11-0057 0 4 PR
,� CITY OF PRIOR LAKE BUILDING PERMIT, Date Re
F ' TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
r
AND UTILITY CONNECTION PERMIT
?'ANN E Sow
!. White City 2. Pink E RMIT NO.
Yellow city / / _ S �/
3. Yd!uw Applicant 1
(Please type or print and sign at bottom)
ADDRESS ie ZONING (office .) 26>4% ,e1
LEGAL DESCRIPTION (office use
LOT BLOCK ADDITION PID
OWNER
(Name) ! l� /f ,
(Phone)
(Address) J� / ���C /..r1 " 44
BUILDER / _
(Company Name) o. ✓ ✓ - 7 •7 ' (Phone) _ U � S 55 5 '�yS
(Contact Name) C , G (Phone) _7_6_3 ,
—� �' 3 , 3 S
(Address) S ' "`y C J /7;11-1 : .- 5' ��
TYPE OF WORK ❑ New Construction klieck ❑Porch ❑Re- Roofing ❑Re- Siding El Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration t]Utility Connection
CODE: ❑LR.C. DI.B.C. Misc: ' 5S { eo 3`7 rJ /i% i}�'
Type of Construction: 1 II III IV V A B rfx 24/ '/ �T
Occupancy Group: A B E F A I MR S U PROJECT 2oST /VeL $
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. I also certify that I am the owner or authorized agent for the
above - mentioned propefty and that all construction will conform to all existing state and local laws and will proceed in accordance with aubmitred plans. I am aware that the building
official can re • ' is per,•,fTor ay Furthermore, i hereby agree that the city official or a designee may enter upon the property to perform needed inspe nos.
l� S‘'/ 2—,
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- Signature Contractor's License No ate
Permit Valuation Park Support Fee # $
Permit Fcc $ SAC
Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewcr/Watcr Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $ J
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other ' $ A / 1
Gas Fireplace Permit Fee $ TOTAL DUE $ / Ni
This Ap • a 'lid Becomes Your Building Permit R en Ap oved Paid Receipt No.
1 Date By
? /j
��- 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 omrpancy. a Certificate of Occupancy must be
issued.
- Planning Dirrxtur 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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ITY OF PRIOR LAKE '(••f /1/ —ke ' r' /es s f,
B ILDINS - PLAN RE tt County, MN � > , t� f ± ° . r t,v-,
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This drawing is neither a legally rarnrdod map nor a survey end 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 = 29 feet
other sources affecting the area shown, and Is to be used for reference W +E --' ;
purposes only. Scott County is not responsible fur any inaccuraclos hernin V
contained. If discrepancies are found, please contact the Scull County Map Date �,
cot t Surveyors Office- _ 9/30/2011 S P_ ', -
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