HomeMy WebLinkAboutFence Permit 16-0018 ®� P�®®� CITE ® PRIOR IL SI E BUILDING PERMIT, Date Recd
TEMPORARY CERTIFICATE OF ZONING CO /
v �
AND UTILITY CONNECTION PE
'yI 4P I.White File PERMIT NO.
A'NES� 2. Pink City 4
3 Yellow Applicant 1(0
(Please type or print and sign at bottom)
ADDRESS ZONING(office use)
LEGAL
�DESCRIPTION(office use only)
LOTC`BLOCK ' ADDITION1 PID �� Ua'lq
OWNER
(Name) r �� L(�� CC (Phone)
(Address) J
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑New Construction ❑Deck ❑Porch []Re-Roofing ❑Re-Siding ❑Lower Level Finish ❑Fireplace
❑Addition ❑Alteration ❑Utility Connection
CODE: ❑I.R.C. ❑I.B.C. Mise. I
Type of Construction: I II III IN V A B YPROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
1 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 local laws and will proceed in accordance with submitted plans. I am aware that the building
Contractor's License No. Date
Permit Valuation Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
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 $ TOTAL DUE $
This Application Becomes Your Building Permit When Approved Paid I Receipt
Dat B
Building Official Date /�e�'�"�V f ij 3�"'•/�� a/�, / Si g �"'t
This is! ify that the request in the above application and accompanying documents is in accordance with the City Zon'�Or�q �y proceed as requested. -quaMent
w n b the City Planner constitutes a tempora ertificate of Zoning compliance and allows construction to co ei1 efok o pancy,a Ccndicate of Occu ,ncy tst b
ued.
-5 ,23, K40
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
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