HomeMy WebLinkAboutFence Permit 15-55 of PRro� CITY OF PRIOR LAKE BUILDING PERMIT, �lJ Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANC l7 -57
AND UTILITY CONNECTION PERMIT '
At 1)VNES01P I.white Fite PERMIT NO. _
2. Pint: City
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS ZONIlVG(office use)
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LEGAL DESCRIPTION(office use only)
4.
LOT BLOCK ADDITION PID Qq(0 , lA/
OWNER
(Name) t✓1C `t+z (Phone)
(Address)
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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
CODE: ❑I.R.C. ❑I.B.C. LKMisc. �' P
Type of Construction: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U
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 1 am the owner or authorized agent for the
above-mentioned property,l d 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 or 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 $ TOTAL DUE
This Application Becomes Your Building Permit When Approved Paid Receipt
Date ftnft,11, B
Building 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 Cit Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy,a Certificate of Occupancy must be
issu VS
Pl nning Dir r Date SpecialCondi ons,if any
24 hour notice for all inspections(952)447-9850
4646 Dakota Street Prior Lake,MN 55372
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The ourchbser.,hal bu rospnsiblu fur any and all rollertior and legal c4asts MATERIAL INSTALLATION
inr=oared by Miurrasl' Ferce in fhe event of ;his bW d cordn,i 3asr, due. -- - - _
fdwest Fence raserves the right to I en -he Irnorove-d PFODery PaymentIf THIS TIMATE VALID F30 X1
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huruvilmi of every nut�sre which wilil interfere with the iritallrc-iian uF th&fb,.e 7h;• tc r .ra groundC.ndj ilns a.ld rarky Gr ek cssive hard digg;nv ho--
esn_2:enicrerf,o naa ugreas.io Fay additrana9 Cos%of lush work..Fe',icIww Nfmcq&mig,Q,shO furniah o<,ly the muterioi and loocir specified in irhis 5an+r_�-. =F r_hcs"made
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