HomeMy WebLinkAboutBuilding 02-0568
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
5-z/-02-
I. White File I PERMIT NO
2. Pink City . ()2-(;~fJ
3 . Yellow Applicant .
ZONING (office use)
12-1
4--4-13/
f/Q/VOI//6 hJ TeA / L.,
LEGAL DESCRIPTION (office use only)
LOT /OBLOCK 2- ADDITION tv / N' 0 57717Z-
PID25-33~- O'UJ-O
OWNER
(Name)
)::' /\/ {J X,
.
/~e: V>tJ
(Phone)
~/Z. &~ 1. 804-/
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
Deck
o Porch
ORe-Roofing
ORe-Siding
,
l"_ower Level Finish
o Fireplace
OAddition
o Alteration
OUtility Connection
o Misc.
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 a aw e 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 pr e to er rm needed inspections.
Contractor's License No.
Date
x
Permit Valuation
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 $ IW"CJ7
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
$
I Paid
Date
/00.0'
..s; - 2 /- 02-
I ~~;!V?,(p
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
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 448 / PtJ/'JOV (E; W T)e;q/ L-
TYPE OF WORK Dcc/::-
USE OF BUILDING /Z-6S IlIIz- __
PERMIT NO. () '2 - osrve DATE ISSUED 5 - ? / - 0 I.__
BUILDER .-c1'51//N kNO)C PHONE # tvl?!; 7. 8o~/
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
'~R DATE
I FOOTING I. I r;/~'7/rJv
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
tF~ , 1
I FI NAL
I 6r 10/II/D'-'
Call between 8:00 and 9:00 A.M. for all inspections I {
FOR ALL INSPECTIONS (952) 447-9850
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