HomeMy WebLinkAboutFence Permit 03-07
CITY OF PRIOR LAKE BUILDING PERMIT, eA.1 Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE ,vv
AND UTILITY CONNECTION PERMIT
1. White File
2. Pink City
3. Yellow Applicant
I PERMIT NO.{),3 -o";fl
I
ZONING (ofliceuse)
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(Please~e or print and sign at 00:
fADDRESS
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LEGAL DESCRIPTION (ollice use only)
LOT ':l BLOCK \ ADDITION ~R.\O
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ID .J..S-:-0Cf'l- Dro-o
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OWNER
(Name)
(Address)
t "'-P\D
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(Phone~~~-Y'-iO -~O~
C,e-\, (.6\- ~<tS-"6~~
BUILDER
(Name)
(Contact Name)
(Address)
(phone)
(Phone)
TYPE OF WORK
o New ConsblIction
ODeck
OPorch
OAddition
ORe-Roofing
ORe-Siding
DLower Level Finish
o Fireplace
DAlteration
DUtility Connection
~ Misc. ~ E\'.>C:C:
(,,'K
PROJECTCOSTIVALUE (exc1udingland) $
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 confonn 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
enter upon the property to perform needed inspections.
~
Signature
Contractor's License No.
SId..O'O~
Date
..
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; 1 ";
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Applicati Becomes Your Building Pennit When Approved Paid
Date
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 City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
.r:;j ZJ J 63
I Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
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