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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
7-3-02-
~. ~i~i~e ~::y I PERMIT NO. /l? - 01'1/1
3 Yellow Applicant V&" V
ZONING (office use)
R/SD
3050
c"e&15K.. V I 2, tv C-11C-C,L,6 s tV
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
(Phone) 1 S. L - dd (,;....dJ 0.)
BLOCK
OWNER
(Name)
H/~?&12-) 6M/LV
/
05'/1 t^16
(Address)
PIDZ5-/33- 04&-3
JO If'
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
ODeck
OPorch
ORe-Siding
o Mise.
o New Construction
~;;;;;5
ORe-Roofing
PROJECT COST IV AL UE (excluding land) $
o Fireplace
OAddition
OUtility Connection
OAlteration
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 are that the b ilding official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the property perfo nee e -inspections.
x
Permit Valuation
.f: 000.00
$ !3 t. z-S-
$
$ 2- 0 0
$
$ 40.00
$
$
$
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
ecomes Your Building Permit When Approved
/-?-crL
Date
7- 3 -.0
-,
L.-
Contractor's License No.
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other 6t-6c;;e / eFJ L- $ 1_ 00
TOTAL DUE CM1W 7-OJ-oZ-- $/.30 z...S
I ~~~~1i'~~;e~fJ,~u/1
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
Residential Building Permit Checklist
Basement Finish or Interior Alteration to Single Family Homes
BY@)
Date: '7 - 3-- 02-
Building Permit # 0 Z ,- 08 / I PID: 2s '/33 . d~ . ..3 Zoning: K/~O
SiteAddress .:3050 ~&K-VI6W C/R-e-LE .sW
Legal: L
B
Subdivision:
Existing structure(~lr NO
I CONFORlVIS TO ZONING
. ORDINAL~CE
YES
NO
YES NO
Is this an expansion of the existing footprint or Refer to Planning
building height? y;
Is the property located within the flood plain? I Refer to Planning I
y:
Does the alteration include any additional kitchens? Refer to Planning I 'tC
Does the proposed alteration include any outside. Refer to Planning
entrances other than patio doors? 'I
Is the proposed use of the finished space or Refer to Plarming
alteration for anything other than a normal single f
family home (office, group home, day care, etc.)?
THIS CHECKLIST MUST BE COMPLETED ..\J.'fD INCLUDED IN THE BUlLDING PERlvlIT FILE TO
MAINTAIN A RECORD OF THE REVIEW.
L\TEvCPLA TE\AL TCHCZ.DOC
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 30SCJ Ge66~VIEW cle Svv
NATURE OF WORK t OW6R_ 1-6V6 L-
USE OF BUILDING .e-5S A/I'<.-
PERMIT NO. 02,- ()8/ / ' DATE ISSUED 7- 3 - 02-
CONTRACTOR /'1/ t,-&6K- PHONE 2Z~ - 22-05
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
- :
I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS'
INSPECTOR
DATE
~ ---- ---
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING if required)
J - Cj -.#<::)
-
- -.
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING ~ lLt . tJi
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card s!lall be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850