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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/32& I //GA//VI A/q
LEGAL DESCRIPTION (office use only)
LOT (p BLOCK / ADDITION
7777/ S
OWNER
(Name)
rr\lr~~1
A.
Date Rec' d
1-26 &-Z--
7-/2--02-
I. White File I PERMIT NO
2 Pink City . 0" - 0 q 11
3. Yellow Applicant V
~/~L--6
/V'b
ZONING (office use)
(21
/..s, #DO AJ.
- oO{P--
(Phone)
(Phone)
y..I\A
(Phone) CfS'"J - L/ O~ r- 6 -sQ ":3
(Address)
TYPE OF WORK
ORe-Siding
IN New Construction
o Lower Level Finish
o Misc.
ODeck
ORe-Roofing
OUtiIity Connection
-co
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 the property to perti rm needed inspec . ons. "
x
BUILDER
(Name)
(Contact Name)
(Address)
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
$
$
$
$
$
$
$
$
Gas Fireplace Permit Fee
7-IBr-Oc.
Date
OPorch
o Fireplace DAddition o Alt:.:ttion
PROJECTCOST/VALUE (excluding land) $ 'l I
Contractor's License No.
Park Support Fee
SAC
#
#
.Jd -3LI-O}-
Date
$
$
$
$
$
$
$
$
D $ 327. ~"
~~~~O(Pcr-1 ~;e'PINOr~
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
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
~--:::: -----' 7/2f:(C'l- ~1' ~~,;::tL..Q~ l'\~ S
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
I Paid
Date
'"
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS J3'2 ~LJie,^i\"\AJ Cfr
TYPE OF WORK ~~huQ _ ~}-~
USE OF BUILDING
PERMIT NO. 02 ..-- 0 Cj / 7 DATE ISSUED '7-/8'" OL
BUILDER j1;c..,-^A-e..\ Qw-,-- PHONE # ~17-.... ?oo-c, ?I?
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
'~R DATE
I FOOTING I I 81?'~ '2..
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
t FRAMING \Jf,UV\ k> I ~ I LJ:r- I f3!Zfo/{JL
t FINAL I t/l;1l I / ( - (- cr?-
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
'"
/'
White - Building
Canary - Engineering
Pink - Planning
Th" ('rnln or Ihr (.alll' Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
~JJ'OPI2 &~
7- /oz-~
The Building, Engineering, and Planning Departments have reviewed the building permit
~.. application for construction activity which is propo~e~ at: 17 .
/3 cJ & I ~/Yl-"/)< 9 ~
. . D'
Accepted
"
Accepted With Corrections
Denied ~
Reviewed By: Date:
Comments: See Revers Side for Additional Information!
,
See Attachments: _ 2) Erosion Control Measures
3) Erosion Control Plan
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
Tht> ("t>nlt>r of lhr I.akr ('ounl,)"
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
~Jz'~~i2 dr~
7- /d-.-~
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for con73U;2CjVitY w2t::;: ~
Accepted pc. Accepted With Corrections
Denied 4-17 I-L I
Reviewed Byif~- v~r-
Comments:
Date: 7 - 2 '1 - tJl ~
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
White - Building
Canary - Engineering
Pink - Planning
The- ('(>nlt"r or IhE' t.kr Counlr)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
.-,.-
APPLICATION RECEIVED
/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
/ ......'
l
I
~_._.~r
Accepted
~
Accepted With Corrections
~
Denied ,
Reviewed B~I_A~~~~
Co
Date:
7/7--,S'-/D7-
".
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
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