HomeMy WebLinkAboutBuilding 02-0543
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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE '"\ )
AND UTILITY CONNECTION PERMIT 5 - I t-l-Or
1. White File \ PERMIT NO }
2 Pink City . 0 Z. -Oh L.~
3. Yellow Applicant . ~ "'r' ~ -
ZONING (office use)
f2-ISO
/72+6
St//V1Grf V
t/ R-. e.,,0&
LEGAL DESCRIPTION (office use only)
LOT 4- BLOCK
I ADDITION l1!oOOVlb W
/...-
,..,:.1
PID
OWNER
(Name)
,A/oV1-7 a~,
,
E,2/U
(Phone) (qS2) 22./' - !'Blt-
(Address)
BUILDER . /
(Name) MvA~)
(Contact Name)
(Address)
~JG-
(Phone) (9!U) 22IP - {,fJl /.,
(Phone)
6b2
TYPE OF WORK
o New Construction
eck
OPorch
ORe-Roofing
ORe-Siding
OLower Level Finish
o Fireplace
OAddition
o Alteration
OUtility Connection
PROJECT COST IV ALUE (excluding land) $
o Misc.
1 hereby certify that 1 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 ~e proPifrtyt perform needed inspections.
X ~,_ J __,~./ sj;.doz.
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 $
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 $jrrz. 4(,
.
rRece!NO
By' ->
,
s our Building Permit When Approved
t Paid
Date
t-i~'-!;{T
J! J-{),56
J
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
wbm "."" by'"' e,<y p","" """"w<o . wm,~" emilh" of '0"" com,-' .., _, co""",- "rom_' ""'" 0='''''' · C"'""^" ofO=,.." m,. b<
issued.
Planning Director
Date Special Conditions, if any
24 bour 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 /7MI7 SU{JfYI Y 6Iee-U::-
TYPE OF WORK .DECK
USE OF BUILDING EF~ A/~
PERMIT NO. O? - 054-3 ' DATE ISSUED 5 - Ie- - 02-
BUILDER #OVl'lchr PHONE# ;Z2-fp-f&,f!I(o
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
[FOOTING J: ~ . I 5~d ......
~CE NO CONCRETE UNTIL ABO' E HAS BEE'N SIGNED
l I
;FINAL 1 tyf J 10 - iI-c)J..
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
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