HomeMy WebLinkAboutBuilding 02-1121
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
9-/0- tlz.,.
I, White File \ PERMIT NO
2 Pink City . 0' 2 _/1/ 7/
3. Yellow Applicant . t:--
ADDRESS
/52,z.-5 /NII.--O.f P/c-?VY
ZONING (office use)
rt/o
LEGAL DESCRIPTION (office use only)
LOT t1 BLOCK I ADDITION 1?~ tv / t"L).r ? ,v 0
PID 2'5'" S? 1'- () 0'1 - CI
OWNER
(N ame)
(Phone)
(Address)
(Phon~)'! [.II L- <7/9 - s~ .2_2-
(Phone)
BUILDERC' . ~
(Name) ) (- \,c. .. . \' ((J'C c \, ';\ ')
(ContactName):0~\,\~ ;~~er ~ S;,:~~('
(Address) I 95 C~ \(11 C' GI...
<7S
TYPE OF WORK
o New Construction
~eck
o Fireplace
OPorch
ORe-Roofing
o Alteration
ORe-Siding
OAddition
OLower Level Finish
OUtility Connection
PROJECT COST IV ALUE (excluding land) $
I hereby certify that 1 have furnished information on this application which is to the best of my knowledge true and correct. I also certify that 1 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 pI!ln,s, I am as?1. e that"the bUi1din~o,.. fficial can revoke this permit, for jU",st cause, F,Urtherm. ore, I hereby agree that the Cl'.ty official or a designee may
enter n i property t . e~f~' ,_ de~ ins ections../ --rb __'" t' / I) .
X . ..... . ')- .-rl 7 c "'- "> I Lo <.{C ( /0 <- Z-
i ature Contractor's License No. Date
o Misc,
Park Support Fee
SAC
#
#
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
Water Meter Size 5/8"; I";
Pressure Reducer
(")
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
$
$
$
$
$
$
$
$
$
1
t ~~ceiPk41
\ ~::. ~~!c;
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
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS '5Z26' 'A~- IL
TYPE OF WORK / :'.'::: (? //'
1..,/ '_ '..-./'---'
USE OF BUILDING ;.::{;.5 /-://~
PERMIT NO. " 7 . Ii 2 ( DATE ISSUED :? '.1' / , ) ::
BUILDER'>""'" S . c<.~; ;: .. /' /..< .. . 3 '" ,-c.: -' PHON E # .' / c :
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DATE
FOOTING 12.0 0 'L
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
FRAMING
FINAL
Call between 8:00 and 9:00 A.M. for all ins
FOR ALL INSPECTIONS (952) 447-9850
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