HomeMy WebLinkAboutFence Permit 03-15
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIAN~
AND UTILITY CONNECTION PERMIT ~
r61.1ab _ _
J White FIle I Pli:RMT'LNO ;n...
2. Pi,k C;ty ~ -' . v".}-I';::;
3_ Yellow Applicanl
Date Rec' d
& .11. C3
(!'lease ~ or mint and si2ll at bottom)
ADDRESS
HOllo 0 "'\~ \\7)W lLL(Ve,.sw ()r,DrloJU M.JIJ ,'Sc:,~I~
I ZONING(officeuse)
LEGAL DESCRIPTION (office use only)
, LO~BLOCK LJ ADDITION \J iI' ovJ S ~ x.J1-. Prlc:ti-h0Vl
.~':e~R tZnhe/+ :S ~"IU\! LP~ .. n QS.)-4l10 -lj.Y1J
) (Address) 1I..1I 0 \J-,\\~ (/AA.R. _0.vJ 0riN' l(JJL.Jl M.l\J s.c:;;-~ I~
'~':;;)ER KnDbla" rA-. p,'Ji lAirs "i:'\~<! ~"""") ~~D~40 ..
(Contact Name) JOhf'l ILtlnb\.Q /J rh / (phone) loc;/$!-).;P-L )
(Addr /" /I ). ,.r I r.. . M4DW~1 ,
ess(_Cin.t.. I m~ M.,f(l~\l'_jh.", 5Y)~II'U.(.MC..I4'Vf, 9..C:J.fku..L W)
~) ~~7S
TYPE OF WORK 0 New Construction oDeck oPorch oRe.Roofing oRe.Siding
PID
C oLower Level Finish 0 Fireplace oAddition oAlteration oUtility Connection
~isc~~ ,t~~ PROJECTCOST/VALUE (exc1udingland) $ 1500.00
j#. _ 1# LIIIIIC-
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 loca11aws and will proceed in accordance with
submi lans. I am ware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
ent po thepto perform needed inspections. ~-oW~I~
:fjY'....) ..a L.lI?-'J s - :::11- D.3
-
Signature Contractor's License No. Date
I Pennit Valuation
I Pennit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
!Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size5/8"j l"j
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
This Application Becomes Your Building Permit When Approved
Building Official
I Paid
I Date
Date
#
#
$
$
$
$
$
$
$
$
$
#
#
I Receipt No.
Bv
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 '-"'r-".... Certificate of Zoning compliance and allows construction to h_._..____. Before occupancy, a Certificate of Occupancy must be
issued.
l~la
-=rrt' -- p-rni. I etor
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(p, II-Db
Date Special Conditions, if any
hour notiee for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
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