HomeMy WebLinkAboutBuilding Permit 12.0017 Fence 461 * PR /o CITY OF PRIOR LAKE BUILDING PERMIT, 0 Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
x AND UTILITY CONNECTION PERMIT ) I
L ,,,,-;NESO:: 2� Pink City PERMIT NO
3 Yellow Applicant `�
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
X43'0 2 EQlv.1 C-W2 -e LE SE
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
OWNER „,, (� / 12 ' £( O — �'i `t I
(Name) �EIc� el 1 k - Ve +hT2 r (Phone) It
(Address) l 3 g 2 e12ahJ Gt (IQ L-LE. Sc Pt2.xbp l,,44 )w) 3 / 'L_
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 1
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc. NL ... )`11 il i 14 Ctirtct4 1 t1” K
Type of Construction: I II III IV V AB PROJECT COST /VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
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 I 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 . • revo. e thi • rmit for just cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
� 1 � v
Signatur' 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 $
Gas Fireplace Permit Fee $ 6-e.L TOTAL DUE $
6
This Application Becomes Your Building Permit When Approved Paid F Nc.t, Receipt No.
Date By
u ilding 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 b:
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
ESTIMATE / ORDER Gopher State (1) Call ID #464 Ticket
4,e/ .0,••_,•�••••_• .�•••;•;•� ••; : ❖::❖ Nearest Intersecting Street
Range
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.lid aSMA #1. }�A 1 QR:T X. f.0 a Hudson Grid .� .Q :Qp.
525 E. Vlllaume Ave. f South 51. Paul, Minnestoa 55075 Corner lot Section /Quarter
(091) 431-2221 - fax (651) 451 -6939 3q / 1
CTL� -- � /592,7Z409-7 Date 9/a Y 20.E
- ,(/ /� r � 1 • q q Job No fix,
'MS �• ��� �s.s � / /+ cy'y�� q / Salesperson sue"
. / Z.,/ y J Olf_l'S((tat��c /�ZZ ,t J
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to Horne Phba§[/ )vl /v /5' Picture No.
Site Address Work Phone ( ) Terms. 10% Down
50% St.H UP
Work Phone (Spouse) ( ) Islen.. To Installer on
I: CPI Thule Completion
Customer Initials
DENTIN DESCRIPTION .cs•
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am Payment: Check # Amt. Date /fi/ 1,, 1 CO 040 'r - 5 / G
Wit Card # Expiration Date O( ),7/ ( v
DPO PS❑ Ic❑ ALL w ;aitre - U,' , 04 0,4--, --- - -/2b h Ut
0 SERVICE CHARGE of 102% pet month (13% Annually) will be applied Of 7 v
n all pest due balances, MATERIAL AND INSTALLATION
rho purchaser shall be responsible any and all collection and legal costs .
ncurred by Midwest Fence In the event of this bill becoming past due. THIS ESTIMATE VALID FOR 80 TAX
Aidweat Fence reserves the right to lien the improved properly if 0ayment
DAYS FROM ABOVE DATE
n full as agreed in in this contract is not received. TOTAL
Owner responsible for establishing ceded ampere, and lame lines. Any Permits required .00110.111e sale responsibif, of the owner. Owner responsible for removal of
obstructions of every nature which will interfere *AA rho installation of the fence. This contract assumes normal pound condition.. Should reAy or excessive hard dipping be
encountered. owner ogres to pay edditional<ash of such wadi. Midwest Now Vida. Co. shall furnish only the moerioIe d lobo specified in Ibis contract. Any changes made
from the above speed e. ion, will be billed at Midwest's current retail prices.
is ardor will bosomo binding only upon Midwest Amos Manag.ris approval
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len2- Rev. 2 -05 Manager Salesperson's Signature sere
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