HomeMy WebLinkAboutBuilding 02-0778
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ADDRESS
4111
LEGAL DESCRIPTION (office use only)
LOTSBLOCK ADDITION
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1. White
2 Pink
3. Yellow
File
City
Applicant
I PERMIT NO.l?;Z - //1 fYl
Blvd
ZONING (office use)
Rls:D
)1 tL,1Vl
;;2/JcL.
PID
--- d-80--6;){,-0
OWNER ,/
(Name) A ; fill d II- r '
(Phone) 9' S-2 -,fr-~ --00 7' 3
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
OPorch
o New Construction
Deck
ORe-Roofing
ORe-Siding
OLower Level Finish
o Mise
o Fireplace
OAddition
OAlteration
OUtility Connection
PROJECT COST /V 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 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
Xenter upon the prop to erfol~ neede~
~ 6h-?~~
Signature Contractor's License No, / Date -
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
# $
# $
$
$
# $
# $
$
$
$ T~1- ~8
I ~ciEtN~3 lfr I
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
I Paid ~73-0Y-
Date '"", 7- 0 a-
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
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS Lj/I~~gg~g~d
TYPE OF WORK Vec.Jc
USE OF BUILDING 5 P
PERMIT NO. O~- /I~ DATE ISSUED ~ -d-I-e~
BUILDER k/+ maN r PHONE # Lf'-!o- ?oC{..:J
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING
PLACE NO CONCRETE UNTIL ABOVE HAS BE
l-. I I I
I FINAL I ~ I 51'2~t'(;g I
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
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