HomeMy WebLinkAboutBuilding 05-0802
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CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT 8( 15 ((J S
(Please
ADDRESS
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at bottom)
White
Pink
Yellow
File
City
Applicant
I PERMIT NO.
05".060Z-
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER \
(Name) ~n;t'_
b; Lsc.v ~ , -r; \ \ P I L..~"o..
.
~\V1-\- Rd S;C'
(Phone) d.Ob- S'doS'
BUILDER - to~ '1 J
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction N'Deck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteratfoi OUtility Connection 0 Mise.
CODE: fLR.C. OLB.C.
Type of onstruction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5
PROJECT COST/VALUE $
(excluding land)
I hereby certify that I have hlrmshed m!llrmation on this applicatIOn which is to the best of my knowledge true and correcl. J also certIfy that J am the owner or authortzed agent for the
above. mentioned proper!)' d that all construction will conform to all existmg state and Jocallaws and will proceed in accordance with submitted plans. J am aware that the buildmg
oke this rmit r JUS use Furthermore, I hereby agree that the CIty official or a designee may enter upon the property to perform needed mspections.
Contractor's License No.
Date
x
Permit Valuation
This Application Becomes Your Building Pennit When Approved
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 CJrH-liO %.1"7 . 1f5 $ I'll, II
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
BlIildlll!! OHicial
P//7Iar
. Daie
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ThIS IS to certIfy that the request in the above applicatIon and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
when si -ned by the City Planner constItutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before "ceupancy, a CertIficate of Occupancy must be
'''" PI'"";"~ ?/I?~;: IL.Q ,& ~
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD .
SITE ADDRESS 153'S' ~~~r_Ii'N~ ~Ikl
TYPE OF WORK ./)ait. ~ii-t.JIk:I1f.tDVr/ntTh.l~.,.,J
USE OF BUILDING "?o~O. ~
PERMIT NO. Os. 0802... _ DATE ISSUED ~/I~ r
BUILDER ~ ~ PHONE #~-;IJ.-S"
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING '6'2-4- ;
IlliiliiliiiiTE UNTIL ABOVE HAS BEEN SIGNED
T 1
[FINAL ] Vtj/] C/- l-f-O<{
DATE
FOR ALL INSPECTIONS (952) 447-9850