HomeMy WebLinkAboutBuilding 02-0770
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
t - (f?-(X~
White File
Pink City
Yellow Applicant
I PERMIT NO.OZ/'O,?10 I
-;;~//j.J ;{' /1 (> I. /
- ,
- 11 /,i'U ;) r--4-
ZONING (office use)
({ S [)
PI
LOT
BLOCK
OWNER
(Name)
I J ;{ Icj~ ;11<' j
v '
, Y')
(Phone)
(Address)
BUILDER 'J --j ,4'. .,/.) /! ./ / /
(Name).) J /< /'<//Iz..)0 /j /-1' /C/l /t~~~J
(Contact Name) f.1",/,f{,(i-C\ L'(Jl('.-J,)-;-:
,/ .]
(>f.1-.
7.' ,.-.-;'
) ,?,\
(Phone)
(Phone)
(Address)
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'//; /~~?>
-
TYPE OF WORK
o New Construction
~
OPorch
ORe-Roofing
ORe-Siding
OLower Level Finish
o Fireplace
o Addition
o Alteration
o Misc.
PROJECT COST IV ALUE (excluding land) $
Ii J)Li iJ
DUtility 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 aware 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 ~~4to perform neede?7ections. t... . /7')
X ~fi, . '/( ( '~ h- ..f;{) / bY ff~ / (, "~
. Signatur~ Contractor's icense No. Date
$
$
$
$
$
$
$
$
(,,, ".0 $ 3
~/1!;~JiY I~~cei~~ 'j,JS/tJ I
Permit Valuation 3. ()(X).tX)
Permit Fee $ 3.~
Plan Check Fee $ Sf .,1
State Surcharge $ I.SO
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
omes Your Building Permit When Approved
\ Paid
Date
~ - ')(p-() 2-
Date
This is to celtify 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
MINNESOTA VALLEY
SURVEYORS & ENGINEERS CORP.
12006 12TH AVENUE SOUTH BURNSVILLE, MINNESOT A 55337
Phone: 890.7750
Certificate of Survey for: George Groenke
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fl('nch ~lark
----~---
Inv. of s3nitary sewer ~H #lhl at
centerline Watersedge Trail NE Jnd
Boudin's Or. Elpv.==89Fi,14
Lo t 16
floudins '1anor Seco!1d ^ddirIG!1
;,tALE.' J " . )0 .
o OENOT.E5 IRONMONUMcNT
x ~)enotes e;<isttng ~lcv,1t ion
Denotes test hole
\~, O. il79-QC)
, he,.by certify ,hot l~i\ i, 0 true ol\d correct '.pr.,.",tolion
010 ,,,,,,., of the bound",.i.' 0' the obo~. deHtlb.d IOl'\d.
ond 0' tn. locQ,ion of oil buddi"9", Ih.,..o", o"d all ___i..hlt'
er\c,oashmen1", If 0"1, fro"" Of' ~ "uid lund.
. ,n .1"1,, on ,n7Q
Mlaulotl Vllley SurHyors &.
E _,I ~ u " . Corp,... /~
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tty . ,~~. <. L. ,." _r ,~_ <" " /, R L
-~ 9293
MIen. RIlII, No.
'"
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS l:lli!J LJ~ ~ 'Ii- I
TYPE OF WORK ~\o..aJ ~\~
USE OF BUILDING Sffi
PERMIT NOo 02-0'7'70 DATE ISSUED Co'" 2~ - 2c:>c:>,"",-
BUILDER ~ U~ PHONE # c.,17..-98k~/c{r
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING I Ih- I 7/~/fJ t.
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I~ rJ;""'j (4-r/~Jd~) {fr'f;;1 ~, /,,13;;1z.-
I FINAL I ~ I 0;'blflZ-
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
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