HomeMy WebLinkAboutBuilding 02-0850
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
7- 9- y
1. White File I PERMIT NO I
2 Pink City . /l? ,. 0 ()$
J. Yellow Applicant CL.~ ~
ADDRESS
l b 3 ?fa
~ 5.~.
LEGAL DESCRIPTION (office use only)
LOT I BLOCK 3 ADDITION
,
/~U:U2
PIDa5 .,.' ~ ')- 0 :).1-
OWNER I I L
(Name) C J\ &t {' e. S,..' Y J1 ,1
,
ZONING (office use)
!J
r, ~_ {''1 , S.
(Phone) J.-2. b ~ 3~ II
(Address) b 3 'if D V: c...:~tlr . ""
?f'/.;;,r L..l&, /J1/V 55-S7.l.
BUILDER...s: Ir ."f I . ~e,-; it
G,,"'-.rl,,':> . ..,
(N ame) c:.. -.;j
(Contact Name) C~LAck f3 e ;+-,'S
(Address) +c., C"'" V ~ S. (
I , ",
(Phone)
(Phone)
1. 2 fc- '!> Lj II
:2). {~ 3~ /I
o Porch
ORe-Roofing
ORe-Siding
TYPE OF WORK
o New Construction
~Deck
o Fireplace
OAddition
OAlteration
OLower Level Finish
OUtility Connection
PROJECT COST IV ALUE (excluding land) $ 2 c::1 co, 0 b
"
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
auth~e~ent fo the above-mennoned property and that all construcnon WIll conform to all eXIsting state and local laws and will proceed In accordance with
sub tted l~ns I am awa the bUIlding offiCIal can revoke thIS permIt for just cause Furthermore, I hereby agree that the city official or a designee may
ente upf tlie pro to perfor eeded inspecnons
X 6 '. J rl- 0 L.
Contractor's License No. Date
o Mise.
Permit Valuation Park Support Fee
Permit Fee $ SAC
Plan Check Fee $ Water Meter Size 5/8"; 1";
State Surcharge $ Pressure Reducer
Penalty $ Sewer/Water Connection Fee
Plumbing Permit Fee $ Water Tower Fee
Mechanical Permit Fee $ Builder's Deposit
Sewer & Water Permit Fee $ Other
Gas Fireplace Permit Fee $ TOTAL DUE
#
#
#
#
$
$
$
$
$
$
$
$
$
/.:J'''. 'lJ I. I Rep- ,Lz. 5"'9
/-/7--O~ By
I Paid
Date
7-(\...o? ___
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 requesled. This document
when signed by the City Planner constilutes 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 /~3J7{) !//ctCJria (!!Lr-U~
TYPE OF WORK De.L Ie
USE OF BUILDING S P
PERMIT NO. QC). - o~ DATE ISSUED
BUILDER c1hud.( mf 5 PHONE# ~d-f., '3L/lj
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INS~ DATE
I FOOTING I I ifl ~/{lZ--
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
If~ I ~ I
I FINAL I ~ I /I~ S -(Jc..
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850