HomeMy WebLinkAboutBuilding 02-0479
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
s:- 3~OZ
Q9,0775
ADDRESS
Date Rec' d
I White File
2 Pink City
) . Yellow Applicant
PERMIT NO. ()? - 0
4575 se/lqvt-L- G/~t~6 fie
ZONING (office use)
;:::./
LEGAL DESCRIPTION (office use only)
LOT
BLOCK 3 ADDITION K/lItJ.6 H/t.-L., Z;V.J:)
PID 25-33'1-- tJ/-O
g; (..~ '^-r d
OWNER
(N ame)
/V1 ur'ld i ':y-r
(Address)
(Phone)
q5:A
4 c./5 -. ('J/ L "7
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
ORe-Siding
OLower Level Finish
ODeck
o Porch
ORe-Roofing
o Fireplace
OAddition
OAlteration
OUtility Connection
tcJ;..cOST /V ALUE (excluding land) $
I hereby certi that I have fumishe nformaf on 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 up he roperty t perfo de~ inspections.
x
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
es Your Building Permit When Approved
5- ? -a-z
Date
5.3 - ;JO()2-
Contractor's License No.
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ .39.Z7
- I
~~~ ff-:;~ol
I ~;~ 4/78"
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, ifany
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
'<1/
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS 15)') ~L;01..d C'r,
TYPE OF WORK lA.)il1\J)c~ Q~S" LJej~
USE OF BUILDING S F..o
PERMIT NO. (j 2., () 47; DATE ISSUED s-: S - 0 "L
BUILDER //t/A/LJ/ll/q6J<? PHONE # #5"-012-9
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
~~ JI
- PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
[~ I.!
I FINAL J ~ f & -J-S~;<, .
Call between 8:00 and 9:00 A.M. . o,:all inspections
FOR ALL INSPECTIONS (952) 447-9850
:
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