HomeMy WebLinkAboutBuilding 02-0477
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/4 lOt
C-t '
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
I g,:;e~R ::\ e 4'
(Address)
Date Rec' d
iJ- ~ )- ..-0 )-
~i~i~e ~~;y I PERMIT NO'OZ,.-/l4n11
Vellow Applicant . V 1_
e'l~. VftlOtL kJ
Jf) (V SS3 2.-
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PID ;25-4 ( 4' D Ict'-
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(Phone)
ZONING (office use)
pU])
BUILDE~ (\ I .
(Name) J 1 J ~ UV\/\ ljC 'It ~i7L vcf i ~ ~~_
(Contact Name)~.fl ~ ~\S Lu otIt7-~ -"',4... '
(Address) 1775'0 t=7z.-i""--( It. ilv.e. ~ #'VI ".,tl~"" yVll()
(Phone)
(Phone)
9) 2. - qti7- tac( b7
~ I:L RD ~ - :2 9 L ':J
SY02-'/
TYPE OF WORK
o New Construction
OLower Level Finish
o Misc.
~Deck
o Fireplace
OPorch
ORe-Roofing
OAddition
OAlteration
~e-Siding
OUtiIity Connection
PROJECT COST /V 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
enter upon the property to perforr~ ~e7~d insP~7
x~vl~flIl. ~ :2-022.5"33S- S--J-~"L
. 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
$
$
$
$
$
$
$
$
5-~3-~~
.....
Date
$
$
$
$
$
$
$
$
5~3-0Z-- $
Park Support Fee
SAC
#
#
I Paid
Date
0.0
/fZ~~r- (TI;-ceiPt~h,06
Planning Director
Water Meter
Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
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.
TOTAL DUE
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
White - Building
Canary - Engineering
Pink - Planning
The Crnlrr of the Lake Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
;1J1t2 Y LA /n ~J1/5fr
.5 "d.- Od----
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity WhiCh. is p.rrooppooSSeead! t: ..
11-1/0/- ~~~~~
~
Accepted
Accepted With Corrections
Denied ') v;) _ L
Reviewed BY{"K (]~~
Comments:
Date: 6-:5 - ;;;(CJt) L
U~ Ckk WoJ
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
'"
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS , 4 JO ( Ce&QJ-~ao~ 0~.
TYPE OF WORK JJ~ ~,(~ J-.- <;;.-J'r
USE OF BUILDING S 1=- D
PERMIT NO_ ~ 2 -0477 DATE ISSUED 5 -3 -02.,
BUILDER --1!J.ax' IIN\. C~ PHONE # (,/2-PK>S-2!f23
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR DATE
I FOOTING I ~ 15/?/c;2-
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I~ I I
I FINAL I I
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
.,