HomeMy WebLinkAboutBuilding 02-0645
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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE / /1~'
AND UTILITY CONNECTION PERMIT ~ - .3-uc;r
; ~i~~e ~:;y I PERMIT NO.()Z -')1- ..;~I
3. Yellow Applicant _ .....t If/q-J .
ZONING (office use)
PUD
5 c--? 0 '1
C~OSJ'/lA/O,eA 0~1 56-
LEGAL DESCRIPTION (office use only)
LOT 8 BLOCK.3 ADDITION CFleO/N/!L- /ZILJGlt:;, 2 JVD
PID z5 - 302 - O~3.3 ~ 0
OWNER
(N ame)
/J1C:-<queLL- 0,
,
e:Q
(Phone)
't.s~ - tj;f7 - 91LJ/ /
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
Deck
o Porch
ORe-Roofing
ORe-Siding
OLower Level Finish
o Fireplace
OAddition
o Alteration
OUtility Connection
o Misc.
PROJECT COST IV ALUE (excluding land) $
1 hereby certify that 1 have furnished information on this application which is to the best of my knowledge true and correct. 1 also certify that 1 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. 1 am aware that the building official can revoke this permit for just cause. Furthermore, 1 hereby agree that the city official or a designee may
enter upon the property to perform needed inspe . ons.
x
G:
Contractor's License No.
b/40~
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 $ L~ .~~
Permit Valuation
.~ -l.. -0 Z--
-\~No.'t2rn
L"- S -o?-
Date
\ Paid
Date
omes Your Building Permit When Approved
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, 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
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS _~& oc; d/ZuJ'S/llvOIC:'/-l S-;.
TYPE OF WORK Ot,C./C
USE OF BUILDING /Z6 S- /ifrZ-
,
PERMIT NO. {i' '2 -()&-?4~ DATE ISSUED to - .3 --0 2-
BUILDER /-lE~Ue:UU, D.:.J PHONE # 44 7- ~ II
NOTE: THIS IS NOT A PER'MIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DATE
r
I FINAL
I MJ q -l~'- oJ.--
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850