HomeMy WebLinkAboutBuilding 02-0750
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
ro" d-'I' ~
(Please type or print and sign at bottom)
I ADDRESS
LfG77
I. White File I PERMIT NO I
2. Pink City 'oa- -1 C-r-'"
3. Yellow Applicant I ::J L..J .
{(JMtJad
~
ZONING (office use)
R- I
LEGAL DESCRIPTION (office use only)
LOT /'1BLOCK d ADDITION
"
(sr PIDd.S" c28o-'
OWNER
(Name)
(Phone) (P ( ~ '- 'f I a - 5?P~
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
eck
OPorch
ORe-Roofing
ORe-Siding
o Lower Level Finish
o Fireplace
OAddition
o Alteration
OUtility Connection
o Misc.
PROJECT COST IV 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 ag~. t 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 e building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
exnter upo e ro~ pe orm eeded inspections.
~ ~-;).lrO'"2-
Contractor's License No.
Date
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 $ I 6 rg 10;0
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
$
{, '-2 t/-02-
I Paid I ,~~- ~ Jiecei~t ~if-~ 3~LI
Date (, - l/ - d- By
!
es Your Building Permit When Approved
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
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
SITE ADDRESS ---E f.o l'?
TYPE OF WORK [::ec..( C
USE OF BUILDING <Z ~Q
PERMIT NO. t?;) - 7.~ DATE ISSUED Cr:,(? - ({ I ~ -~c, :JO
BUILDER ~.'d.... Jc~~ t- PHONE #&,{~... LJlg-5~~D
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
a<c. ~~/"'J- Cr.
INSPECTOR DATE
I FOOTING I J$;- I ~t%~OZ-
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
r FRAMING ~foYe 1,^~hJ.{,~ kfc.~ I VIti I q - ()-Ot.
I FINAL l1j7 I JO /}?6~ JI/
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850