HomeMy WebLinkAboutBuilding Permit 03-0468
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
/ hh,~{p W,'" d5Ov- &tn ~
5'6
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
PK1n~Le
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc,
M - ~ ~ -furf"rt
Date Rec' d
4-Z3-03
I. White File I PERMIT NO. 0) -=>- 0 AIr I
2. Pink City '....;} ,.,-ro
3 . Yellow Applicant
(Phone)
(Phone)
(Phone)
o New Construction
J8(Deck
o Fireplace
OAlteration
OLower Level Finish
OPorch
ORe-Roofing
OAddition
PROJECT COST IV ALUE (excluding land) $
ZONING (office use)
jelSO
PIDU--3s~- 0/3-0
95;;- WD- 3~/}q
ORe-Siding
OUtility Connection
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 a 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 prope to fvuu needed inspections.
(/
Signature
x
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
/000, (') 0
3S.7S
"2-'5. r ~
.'50
This Application Becomes Your Building Permit When Approved
~ '=f~
Building Official
4/c)3~.3
I Da'te
Contractor's License No.
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
:b &,ti ito
, C-j, rl.:?>-D-:j
Paid
Date
#
#
#
#
J./iyyl/l 3
~I
$
$
$
$
$
$
$
$
$/ d-I- ~=3
. -"..,
Receipt No. 4~06 'I
By ~__
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
'oi
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS 1h!tJ(Z)6 W/ND..501C:.. LANE:
TYPE OF WORK f)6{!/C
USE OF BUILDING /2(5S /4 lie-
PERMIT NO. _ o...? -,{)4?:,cf bATE ISSUED cr. 23 03
BUILDER ~ I U/2.fl1 PHONE # 4--'/f-()-sS74
,
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 I {I1If I L.I "L,f'V>
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
FRAMING I I
FINAL
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 rJ"""-/l(
ADDRESS /{C b~ W,Y1(J.>,,, L ~'\
OWNER CONTR.
PHONE NO. PERMIT NO. s-L((,?
o FOOTING o PLUMBING RI o EX/GRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
0" FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
~ FINAL Q.{*t...t o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
/'
I
V
\ O~
.f/..
./f l..t
9""WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: (/IIf S- / l1... 0) Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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