HomeMy WebLinkAboutFence Permit 13-03 otig * PRie CITY OF PRIOR LAKE BU .. : . ' RMIT, Date Rec'd
4. TE MPORARY CERTIFICATE 0 ZONING C I MPLIANCE
AND UTILITY CONNE . ' ' ' IT F5-Afe&---
4,....0. ; . w hite File P ERMIT NO.
Yellow Applicant /
3 Y i
elliwni
(Elease -type rint and sign at bottom)
CADDIESS ' ZONING (office use)
/ WO S (01.x5 e C l ) ij g
LEGAL DESCRIPTION (office use only) ' I �! et Gl
LOT BLOCK ADDITION PID l`l
(Name)} 4/(4/1 j 6 /, > (Phone))) 6 /2 5 S 9 /5
•
(Address)
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK 0 New Construction ['Deck ❑Porch ORe- Roofing ['Re-Siding ❑Lower Level Finish 0 Fireplace
❑Addition ❑Alteration OUtility Connection
0 Misc.
CODE: ❑I.R.C. ❑I.B.C.
6, ' 1 VII
Type of Construction: I II III IV V A B
Occupancy Group: A B E F HI MR S U PROJECT COST /VALUE $
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 I am the owner or authorized agent for the
above - mentioned property and th 1 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 revok this ., rmf rg a , . ... -- • • hereby agree that the city official or a designee may enter upon the property to perform needed ins! ctions.
Signature Contractor's License No.
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; I "; $
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 I $ TOTAL DUE $ 0.—,
This Applica t . 1 ; . . mes Your Build ing Permit When Approved Paid Receipt No.
4 , T . (3 Date By
• it ing Official Date
i -
1
This is to cert' 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
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447 - 9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372