HomeMy WebLinkAboutBuilding 02-0405
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File I PERMIT NO 9 I
2 Pink City . '" 3-- 7S.
3. Yellow Applicant , f-/_
ADDRESS ZONING (office use)
tv, U),
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
;(fOr) Le; Frq J'1 ( e
IS~tAS I-~i;-WOV /-/6
r
OWNER
(Name)
(Address)
(Phone)
7' 5"/-. V'IJ - O'i-J..J
c.l
MU,
~/Oy /c, R;
M /V ..s .$J> ;/ ,,;z
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
ORe-Siding
o New Construction
o Misc.
OLower Level Finish
PROJECT COST IV ALUE (excluding land) $
~eck
OPorch
ORe-Roofing
o Fireplace
OAddition
DAlteration
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 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 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.
x
Signature
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Approved
Contractor's License No.
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ 138.~
J~r;ff'?'
I ~~"'iPtN~Z.1
Paid
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.
Planning Director
Date Special Conditions, if any
24 hOUT notice fOT all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File I PERMIT NO a
2. Pink City . A~ _",..r'",
3. Yellow Applicant . V l.- '-"'\V_
ZONING (office use)
Co-t-{/; N, W.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER Jd, /; I
(Name) J111t' /1.
6. L.cr ha J1 {" -(
(Phone)
rSd~ tI'IJ-OC}';';;
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
ORe-Siding
[gDeck
OPorch
ORe-Roofing
o Fireplace
OAddition
OAlteration
OUtility Connection
PROJECT COST IV ALUE (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 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 official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enteJ-?the property to pe~~eeded inspections.
X ~1./t If A' ( ti:~<-#~'\. L/~r:;l;J-dOO.)
Signature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
ecomes Your Building Permit When Approved
4- 2..S02-
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $
I Paid ~
Date _
I Recei:tlNo. q I 7 ~?
By r;. ~
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.
Planning Director
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
PRIOR LAKE
INSPECTION
RECORD
~:EA~~~~:K ~~ ~';:~ ~:1/; d-
USE OF BUILDING S€- D _
PERMIT NO. en- 0:0'> DATE ISSUED t(~"2 3- C <-
BUILDER ~+'U.l ----f' PHONE # 9;52-c..(~7-65 2~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
FOOTING 1>
PLACE NO CONCRETE UNTIL ABOVE HA
- I
~
DATE
I f!3 I
Call between 8:00 and 9:00 A.M. lor all inspections
FOR ALL INSPECTIONS (952) 447-9850