HomeMy WebLinkAboutZoning Compliance 12.0043 Fence O Pill CITY (t CITY OF PRIOR LAKE BU _ ! • . ' , ' IT, Date Rec'd
,, r TEMPORARY CERTIFICATE F ZONING C • MPLIANCE
I 7 AND UTILITY CONNE i . • ' MIT 5. 21./2_
4INNESO).1 i. white File PERMIT NO . D ���JJJ
2 Pint: City �� _ /L�
2 Yellow Applicant
7
(Please type or print and sign at bottom)
ADDRESS _ / ZONING (office use)
2_S l30 sPred/ -/ 4-�t 6 O `,
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID
VIM k• st 1 P (Phone) -
A'
(Address) f b ‘ 1 7 L f'G gb 1 d `'� 9€ - M N 5319
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ['Deck ❑Porch 0Re-Roofing ❑Re- Siding ❑Lower Level Finish ❑ Fireplace
❑Addition ❑Alteration ❑Utility Connection
y(Misc. _____ 65– — 6:2 Pit (41 I7
CODE: ❑I.R.C. ❑I.B.C.
Type of Construction: I II HI IV V A B PROJECT COST /VALUE $
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have punished 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- 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 budding
official can revoke this permit for rust cause Fu t. more, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X ,, . - _, / .6/ _ �` :urn
Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; I"; $
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 $
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This Appli� , . • es Your Building Permit When Approved Paid Receipt No.
t ij ' r • 2-Z-.12-- Date By
d
uildine 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
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This drawing is neither a legally recorded map nor a survey and i s not Map Scale N
intended to be used as one. This drawing is a compilation of rec
information, and data located in various city, county, and state of ices, and 1 inch = 17 feet
other sources affecting the area shown, and is to be used for reference W E .ir ,
purposes only. Scott County is not responsible for any inaccuracies herein :_ _ - - " "'
contained. If discrepancies are found, please contact the Scott County Map Date
Surveyors once. 8/22/2012 S
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