HomeMy WebLinkAboutFence Permit 15-39 ►VV
®F PR,,�� CITY OF PRIOR LAKE BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE /
AND UTILITY CONNECTION PERMIT �� l
��N'NES0,P I. White pile . ` + ;J
2. pink City PERMIT NO ' J ;
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID
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(Naim ER �\� '��`��/��y� �� ��/`� t �� (Phone)
(Address) �-- �� l l� "t1�0\�'� �� NVQ C, 7
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑New Construction ❑Deck ❑Porch ❑Re-Roofing ❑Re-Siding E]Lower Level Finish ❑Fireplace
❑Addition ❑Alteration ❑Utility Connection •I
10
CODE: ElLR.C. ❑LB.C, isc. =
Type of Construction: I II III IV V A B PROJECT COST/VALUE y4 br
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5 (excluding land) ow
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 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 this permit for just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X
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 - $
Gas Fireplace Permit Fee $ TOT $
This Application Becomes Your Building Permit When Approved Paid Receipt No.
Date B
Building Official Date
Th t 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
W
en sr ed by the City Planner constitutes a temporary Certificate of Zoning compliance anndallows construction to commence. Before occupancy,a Certificate of Occupancy must be
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Planning Director Y\1 Date Spec1qNgpititions,if any
24 hour notice for all inspections(952)447-9850 r
4646 Dakota Street Prior Lake,MN 55372 `? i_,,,
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Scott County, MN
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Disclaimer_Map and parcel data are believed to be accurate,but accuracy is not guaranteed. This is not a legal Map Scale
document and should not�FPROVEba title search,appraisal,survey,or for zoning verification. 1 inch=37 feet
7/9/2015
Builds Date �—
Zon;, Date U
an., -- Date
http://gis.co.scoff.mn.us/ScottGIS2.OPrivate/WebForms/Print.aspx?img=http://gis.co.scoff.... 7/9/2015
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