HomeMy WebLinkAboutFence Permit 03-25
t-
,
lease or' t and s'
ADDRESS
/(P;). YO
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANC~
AND UTILITY CONNECTION PERMIT b
I PERMIT NO. 63-.:;:s- I
Date Rec' d
l. While File
2. Pink City
3. Yellow Applicant
at bottom
Vu. Il.( Y-It f.)oE- S. E.
ZONING (officeu,,)
p~~
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER17, ..
(Name) lA/..A-{ /L(lfi 61
(Address) /&-3/1 D
j)L.,,""uAed
J4oc:. S'. C-.
,c...I
(Phone)
BUILDER
(Name)
(Contact Name)
(Address)
(phone)
(Phone)
TYPE OF WORK
OPorch
iSC.~
o New Constnlction
ODed
ORe-Roofing
ORe-Siding
OUtility Connection
OLower Level Finish
\~Lt k}.- Vi' K
o Fireplace OAddition OAheration
~COST/VALUE (exc1udingland) $
I hereby certify that I bave 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
enterQ:u the property to perform needed inspections. . /
X ~&j--rV}IA<A____ '#-tU~h'Uit<>~J ",laY/allte ~
r--r ' r (Signature ' - - -- -~on~actor'sLicenseNo. -;-. ~
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Gas Fireplace Pe
Date
Park Support Fee
SAC
#
#
Water Meter Size5/8"j l"j
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
on Becomes Your Building Permit When Approved
'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 cllmmenc:,_ BefDf~~.!.ancy, a Certificate OfOCC:pan~
~sued. ~ L.U--.lC- U""" I <!..9-
7'~ '0"3:; (}l..L.+4-ld.t. ::;I~' :+- eL-t2l.
Date Special anditions, if any
Z4 hour notice for all inspections (952) 447-9850. tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
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