HomeMy WebLinkAboutFence Permit 15-63 (Temporary) ®F Moi CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
.� AND UTILITY CONNECTION PERMIT C `�✓'��
��NNES��P I. white File PERMIT NO.
2. Pink City
3 Yellow Applicant
(Please type or print and si n at bottom)
ADDRESS ZONING(office use)
4-27,5 si-c� -ui_t ., Ci l C,l. �f�� �� I/ , IJ
LEGAL DESCRIPTION(office use only)
LOT BLOCK ADDITION PID 017-6)
OWNER �•"p _ 2 p
(Name),��K� (�T!+'�'U (Phone) (752 )-J Z 7
(Address) 4—,57-5 C& , Pi?tol� LAKc7lNJ J -55 J 7
BUII.,DER n
(Company Name (Phone)
(Contact Name) f , f51-j— (Phone)M 15 Z U2-7 /q 96
(Address) ��
TYPE OF WORK ❑New Construction ❑Deck [-]Porch ❑Re-Roofing ❑Re-Siding E]Lower Level Finish ❑Fireplace
❑Addition ❑Alteration []Utility Connection
CODE: ❑I.R.C. ❑IB.C. ,Misc.�GMu/g7f rtjcG
Type of Construction: I II III IV V A B PROJECT COST/VALUE $ D
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 ha a rr shed 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-mention rope d hat 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 red k this p i f just cause. Furthermore,I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
X f 1
Signature Contractor's License No. Date
PertnifWajdation 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 Application Becomes Your Building Permit When Approved Paid Receipt N
Date B
Building Official Date 0IIK//-���'r
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 Cert tcate of Occupancy must be
issued
LA5 , Cie-L a✓��Pu a '�cJrn ���n�
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Planning Director ate I Special Conditions,if any
24 hour notice for all inspections(952)447-9550 PVA CCn-V_`N (- CR 611
4646 Dakota Street Prior Lake,MN 55372 Pe-1 IY\LA�is5�� wo
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Temporary fence
Map created on 11/25/2015
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' ' misinterpretation. The preceding disclaimer is provided pursuant to Minnesota Statutes
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