HomeMy WebLinkAboutBuilding 02-0758
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(p. ?~~CJZ-
White File I PERMIT NO I
Pink City . 6'" ,. 01Sa
Yellow Applicant c.".- V ,
fArf:-WA
eo tJ(L.::t tJ . W
t-rTS
ZONING (office use)
02-- 7S8
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
PID
BLOCK
OWNER l\-..-..n n
(Name)_ ~ I UV\-efZhD~, !A:-~~
(Address) 52--3 r- A-t (LWA H TS L D LJ (L1 N I vJ
(Phone) qS2 ...-1-Zlo ./ ~b'-i
ck-<-'- ,5 <--q<i4 - r ro 7C::;
L
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
OPorch
ORe-Roofing
ORe-Siding
TYPE OF WORK
OAddition
o Alteration
o New Construction
OLower Level Finish
o Misc.
PROJECT COST IV ALUE (excluding land) $
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 awa~t at the ,bUilding official can r.evoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter the prop'erty t pe fo m.neJde~nspections.
X " LAA..vte VS-DN t. l- ~ ,C) z.-
Signature Contractor's License No. Date
Permit Valuation L-OOQ. _
Permit Fee $ C 1. L .;
Plan Check Fee $ 4 S- ,01
State Surcharge $ (-UD
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water 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
$
$
$
$
$
$
$
$
$ liS. 2."
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.
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
Planning Director
'<#
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS /5239 FI"9/-€.Wf'l Y H&/GIt7::s
TYPE OF WORK OEe/G
USE OF BUILDING /265 /}/~
PERMIT NO. () Z. ~ 7Sf?; , DATE ISSUED (b. 25. 0 2-
BUILDER 1-I/t-/"/6RSCJ/LI PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
FOOTING
PLACE NO CONCRETE UNTIL ABOVE HA
I FINAL
(
,~ Vi
1 15--1 /O~ 1
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850