HomeMy WebLinkAboutBuilding 02-0982
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
/~53o
g~u~&ep TE Ale
LEGAL DESCRIPTION (office use only)
LOT ~ BLOCK / ADDITION
White File
Pink City
Yellow Applicant
PERMIT NO.(J:;z._qr- d-...
(
P?/OlZ LA-~
ZONING (office use)
12/
PID CJ--.S--....
(y- 005-
OWNER
(Name)
f3tlL.4W VAN' ltA-.,A V/ A
(Phone)
95"~- ~?~ - OS'?r
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
OLower Level Finish
OPorch
ORe-Roofing
ORe-Siding
eck
o Fireplace
OAddition
o Alteration
OUtility Connection
PROJECT COST IV ALUE (excluding land) $
/;200
o Misc.
1 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 p~ ~ perform needed~ections. .
X ~ ~, ~W a//~/oz.
, 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 # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ I \ 5'. "2..(;:.
I Paid j~f,:' d-b;3
Date . . "'1 d--. 0--
I ~;cetp~ 'I rl ? J c.r
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
RECORD
SITEADDRESS /t/S36-~dJ~
TYPE OF WORK Oec/c
USE OF BUILDING X
PERMIT NO. (Jd. - 9 b'- d-- DATE ISSUED k - /d-;)...
BUILDER~ lJa/'fl ~a PHONE # L/7k ()~r4
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR DATE
I FOOTING I 13.r. I 9'/ 1 ~() 2-
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN S GNED
I~ I I
I FINAL I *- I 1P/;f!'/'D~
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
~
SCALE: 1" = ;50'
IMJ' or.1 - IV'" VI" ~UUNDAnON ELEVATION
~N'076 : NO TTZeES ON fHLS J.../)T
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I kereby certify that .". III III a true and c<<r~tatlan af a t,rgct ae lIItawn and d.ecrIbed
hereon. As prepared ~y me this :J:!!L day of , 19!J/i. .
: f ~ Minn. Reg: No.~
. .
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