HomeMy WebLinkAboutBuilding 04-0804
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
~t6t
~+v- <;1.
LEGAL DESCRIPTION (office use only)
LOT 1 BLOCK -3 ADDITION 12
Date Rec' d
I White
rink
Yellow
I PERMIT NOtIL/...1 goy
File
City
Applicant
ZONING (office use)
~ :Pv-;'\..- l~
I (}1U~
PID .2')' -() 0 f- () 11;-
OWNE~
(Name) ~#\
At.\ v~
CWAS~('
(Address)
(Phone)
L\41 . ?z>1Y 1<7
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New ConstructIOn ODeck OPorch ORe-Roofing ORe-Sldmg OLower Level Flntsh 0 Fireplace
OAddItion ~AlteratlOn OUtihty Connection 0 M~c.l . \.... tI A
~ 'Z.!-!l" f)oOtt..- ~ el~~ v...J~ I
CODE: .R.C. DI.B.c. - - PR{!P-CT COST/VALUE $
Type Construction: I II III IV V A B (excluding land)
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
I hereby certify that I have furnished mformation on this application which is to the best of my knowledge true and correct. I also eerlify that I am the owner Dr 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 buildmg
otlioaI can revoke thIs pelmlt for Just cause FlIlthermore, I hereby agree that the CIty officIal or a deSignee may enter upon the propelty to perform nee~ lOs~tIO~S. ,.,J
X cD .O~ c1s..s--- ~/~lf2tr ~
Stgnature Contractor's License No Date
Permit Valuation (7t:J,OO
Permit Fee $ ou-; 00
Plan Check Fee $ ,1,5
State Surcharge $ , $"0
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When Approved
~~,~
BuildllH! Oflicial
78o~v
, Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ ~/, 75
Paid
Date
tz;' ~
(~? I
-1 cvOtf I
Rec~. i t No.
By
t
tI
7y, -3? I
ThIS IS to certify that the request in the above applicatIOn and accompanymg 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 Zonmg compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITEADDRESS ~~~I. l>A-::;-A.. ~~~T s..E.
TYPE OF WORK ~ Tino~ Id___! _ ~ tfI'€NI'1 / /JtJpIe.
USE OF BUILDING SF; b. -
PERMIT NO. () 'I - 0 1'(; f DATE ISSUED 7/30/ iJ ",
BUILDER ~t+ CRltSwe'lA- PHONE# '1"'.''''7
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~IL AB:::O:AS B!EN SI:n E
FRAMING
PoSS d3.LE <2Le.c:h2.ic~L
FINAL
FOR ALL INSPECTIONS (952) 447-9850