HomeMy WebLinkAboutBuilding Permit 03-0290
Date Rec' d
.:3 -/8-03
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yellow Applicant
PERMIT NOo03_ 02-'jfJ
(Please type or print and sign at bv..v.~)
ADDRESS
ZONING (office use)
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LEGAL DESCRLt'uON (office use only)
fVlL- oS .5" 771
PID2-t5-37S- 022-0
LOT? BLOCK.3 ADDITION
OWNER
(Name)
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(Phone)
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(Address)
BUILDER
(Name)
(Contact Name)
(Address)
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(Phone) i15:2. - Lj"1 [)- II sO
(Phone)
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o Fireplace
~onstruction
OLower Level Finish
ORe-Siding
ORe-Roofing
OAlteration
OPorch
TYPE OF WORK
OUtility Connection
OAddition
410GO
PROJECT COST/VALUE (excluding land) $
,OMisc,
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 t1-e Pfoperty.to perfO~~.ed.ed ~ inspections. 2 . Q . /l
X -ill~A 0~-itt~VV^- lD2 I L' II D _::)-1 r,) --0 :J
. SlgD,ature Contractor's License No. Date
I Park Support Fee # $
I SAC # $
I Water Meter Size 5/8"; 1"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
I Builder's Deposit $
IOfu~ $
I TOTAL DUE ~ 1,Zf)-4'l Y III '-f.L
- - .- I "
I Paid / f.J Z. ~ I ReceiptMo. 6lf7~
I Date ;/ - ZV -07 I B"J
4;(}d() OJ
q 7.J-J
(P:J,J-I
:2.00
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
Th~iIJ~PAati7Jres Your Building Permit When Approved
IfVL ~ ']-((-dJ
Building Official 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
=Yffi (}E:~' - c.-. '~~:~~;:remd _,ro;::;, ro~ B.=~7:';:= =.b,
\.llanning 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 /6"35((:; /3/q HoKA/ /'/lSS
TYPE OF WORK Of: (~
USE OF BUILDING /6{5S AIR..-
PERMIT NO. ()3- () 7..C10 DATE ISSUED .3 - /8 -03
- ,
BUILDER F/20/l//16if::!.- ~o/llsTe. PHONE # #0 - 7750
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
~N~OR DATE
. FOOTING I (jJ)l I 5~ n
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
rFRAMING I I 1
~J
, r FINAL 1n IU-,1
., r
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
[-9-03 &M1
ADDRESS 1535(0 'tS~ ~~'""'" ~~~
OWNER CONTR.
PHONE NO.
PERMIT NO.
3-~CfC
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
)it. FINAL oed:-
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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~. ~ LA .sk:u.. A'=r--e C-{
0~J O~~&.
o WORK SATISFACTORY, PROCEED
)(CORRECT ACTION AND PROCEED
o CORRECNRK. CALL FOR REINSPECTION BEFORE COVERING
Inspector: I ,j f\ . Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
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