HomeMy WebLinkAboutFence Permit 03-11
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(fj)'
JPERMIT NO. 07:::,- I ,
I. While File
2. Pink City
3. Yellow Applicant
(Please!VD~ or orint and SiD at bottom)
ADDRESS
-----1-( 2J/7;:::-,..,..,~...YL,~ .c.'~ $~
LOTV BLOCK \
LEGAL DESCRIPTION (office use only)
OWNERf) \
(Name)~~_''''
(Address) -<... <U.. "^"'-- '-'L
~
ZONING (office use)
P-I
ADDITIONRe.pIW of
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(lJVolcs V tile ~~ PID J-S-l 57 - oc::0-C'
~~r-L~ \\"S
(Phone) ~:)-- 97- ~,,;)()
(1 .LJ r--l "" ~r.. \ ~ \\ 'S
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
'!if Misc. 1-~F1 c.-€-
(Phone)
(phone)
o New Construction
ODeck
OPorch
OLower Level Finish
DAlteration
ORe-Roofing
ORe-Siding
OUtility Connection
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 t'~"'Y"..J' and that all construction will conform to all existing state and local laws and will proceed in accordance with
sUbIWFflaDS I am aware that the~.. g of!icial can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a desIgnee may
enter on er~~ m ectlons _
X It .
Signature ---.,., Contractor's License No. Date
I Pennit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Pennit Fee
o Fireplace
OAddition
PROJECfCOST/VALUE (excluding land) $
$
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
City SAC and WAC
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 ReceiptNo.
By
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 L__r_...... Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
0'4--.~
Date Special Conditions, if any
24 hoilM!6tice Cor all inspections (952) 447-9850. fax (952) 441-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
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'APPROVED~
PLI\.NNING DEPT
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s:-.~d~Dat8I.o'~'Ob
DESCIUPTIotl:
Lot 6, Block 1, jlEI'LAT OF BLOCK OIlE BH(JOK~.iVILLJ~ HILL:"; TllIHlJ ,LI,lT ['H':; Scott. ':OlInSY, lii"'i>'sotn.
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I ~)' C'mify ,luIt (hi, """'t'y. pisn.1If' repurt
""'. J'ft"l'JArt"\1 h)- f1l(' or unfl('r my llirt~t auPft"t'
,. :";00 ond lhol , am n duly f{('l!i..t>rod LnMd
Sunt>Yllr und,'r tbe Ill"'" (.f 111(, Stnteof Mion.
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File No. ')r)6"
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