HomeMy WebLinkAboutBuilding 04-0229
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2 Pink City
3 Yellow Applicant
I PERMIT NO. 04-. 02.2/1 )
f
ZONING (office use)
PUD
ADDRESS
/5/9&
yVOO 0
J7Ut:t I L
DuM::-
tVW
Date Rec' d
() 4. () 7. 04--
LEGAL DESCRIPTION (office use only)
LOTZA BLOCK I ADDITION
me hi I LOS 21"1::)
PID Z6. :$2.3. 02/.0
OWNER ._? "
(Name) ('" /5/1,3 Ik /:5(:-/ lei
'J?j
(Phone)
Vtlj
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
Lft;l-/3)5
o New Construction
TYPE OF WORK
eck
OPorch
ORe-Roofing
OLower Level Finish
o Fireplace
OAddition
o Alteration
o Misc.
PROJECT COST IV ALUE (excluding land) $
ORe-Siding
OUtility Connection
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 Jlerfor eeged inspections.
.<<;~ /
x
#
#
Contractor's License No.
Permit Valuation
Permit Fee $
Plan Check Fee $ $'). 3~
State Surcharge $ i.:J 0
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water 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
Y-?-o''l
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 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
SITE ADDRESS /5/90 WOOD JJUt:1C-
TYPE OF WORK OCe;c
USE OF BUILDING ~5 HI IL
PERMIT NO. () 4 . 022-0 6ATE ISSUED 4-; 1- '0 ~
BUILDER J-/06t/--I /~9 PHONE # 4-~7; 1?75
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
FOOTING
PLACE NO CONCRETE UNTIL A
I FRAMING I
r FINAL I
DATE
OVE HAS BEEN SIGNED
YJA// I ~- 4 -olf
I
FOR ALL INSPECTIONS (952) 447-9850