HomeMy WebLinkAboutBuilding 02-0457
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
S20\
De-iv-f' lei d
L(). Y\-L
Date Rec' d
I White File
2 Pink City
3. Yellow Applicant
~-I-()d-J
I PERMIT NOG'~ -{Y/51
SE:
ZONING (office use)
I!I
LEGAL DESCRIPTION (office use only)
LOT r BLOCK ADDITION
OWNER
(N ame)
A \tt Y\
bye..e. n e.......
(Address)
S2-0' Dt-tv:f1e\&
ltL n e...
BUILDER . ..
(Name)~n+lfv- r~oV1~~ C-hbY)
(Contact Name) ~-hsY)
(Address) \ 44Dt> g~..H'\S.V\1l
TYPE OF WORK
o New Construction
OLower Level Finish
o Misc.
/l/d
PID
(Phone) Q5'2.- - 4-4- () -- 4 Cf I 'L--
~&
(Phone) Vl52 - 44D _. -, -, S ()
(Phone)
to
D~k o Porch
.sofa \ yeLLs.. e.. tin I '"
o Fireplace OAddition
ORe-Roofing
ORe-Siding
OAlteration
OUtility Connection
PROJECT COST IV ALUE (excluding land) $
D DJ) b
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
;ter upon iL~Zto perfth~sv 2D "Z.ILP I L G ~ / I I 01..-
Signature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Pffiiliy $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
s Your Building Permit When Approved
5- 1- Oc
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 $ 3Q, d../I
I Receipt N~ '1i4- (L
By l /
1..
Kaid
Date
Jf(1~
t - - Od-....
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
SITE ADDRESS 520 r D~J:lt h'~ , d. :e----
TYPE OF WORK S+~h ~ ""'- \:he. ~
USE OF BUILDING .s l=='-f\
PERMIT NO. 02.. - 0457 DATE ISSUED
BUILDER --FIOlA ~ ('-e.J CcV'-')'\t-<..-cL..>-y PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
,'EPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
~ I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I~ I I
I FINAL I ~~ , 5" /'810 z-
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
DATE
"