HomeMy WebLinkAboutBuilding 04-0889
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CITY OF PRIOR LAKE BlJILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/z.//.o3
White File I PERMIT NO I
Pink City . 0 A_. 0 oCJO
Yellow Applicant ~..... ~
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDZ
OWNER
~
(Name) c_
LAK~
ZONING (office use)
(Phone) ~~.,. - -r $ F 2
(Address) 17&
BUILDER
(Name)
(Contact Name)
(Address)
....lA-hAE
/fL
.--
r~.1Z6)(J"~S
r
(Phone)
(Phone) .v~7 - tf89:J-
DDeck
ORe.Roofing
ORe.Siding
TYPE OF WORK
,W New Construction
OLower Level Finish
OAlteration
DPorch
o Fireplace
OAddition
o Misc.
.e. c,
~dl
PROJECT COST IV ALUE (excluding land) $
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 perform needed inspections.
x
#
#
Signature
Contractor's License No.
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
$
$
$
$
$
$
$
$
,00
Water Meter Size 5/8"; I";
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
This Application Becomes Your Building Permit When Approved
~~ -:J/;t!p
, Building Official
~/6r
Dae
/:J -0' - t'.~
Date
$
$
$
$
$
$
$
$
$
911 ~ cr
bate
This is to certilY 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
iS~ ,.. -7..... /?
~-'Y ~ (...., ;r ~~
Planning Director
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
Tht' Cf'nlf'r of Ihf' L.kf' Counll1'
qhite - BlJilrli~
anary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
~/TY 0 F pf2../ Of- LAKE"
/2... / I. 03
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
ElGIE A-lIF:. (Ull&EF"IWt0T
/
PIC)
Accepted
Accepted With Corrections
Denied
~ ~ Date: ijI~<j
':J-M/~ ~_ ~ ~th--
Reviewed By:
Comments:
"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' Ct'nlt'r fir tht' Lab Countl"}'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
. '. i,
i "- '
I .
I :
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
.'
Accepted
/
Accepted With Corrections
Denied
~~
Date:
5f;/ tlor
Reviewed By:
Comments:
"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 o'i" callcel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
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NOTE:
IN SELECT TREE CUTIING AREA
TYPE A SEED AND MULCH
(HAND BROADCAST AS NEEDED)
1
100% COCONUT FIBER BLANKET I
FOR OVERWINTERING OF SITE i
ALL PLANTING AREAS ; ,-'
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TYP E A l::.-
SEED AND MULCH f~
LOW MAINTE:NANCEliuRF MN/DC-:- 60B
JROVED
PL G DEPT
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RESTORA TIO/\J,/PL;6\NTING
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PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD ·
SITE ADDRESS ~Jt.iE AI/$. 7ZAL4 ~
TYPE OF WORK
USE OF BUILDING ~
PERMIT NO. 01/. ~e.e9 DATE ISSUED c1
BUILDER 1lr1oF ~tAd PHONE#~-?81Z.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
I FOOTlNGl ywJ 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I FRAMING I fMI7 J
] ,;1,;1 {
DATE
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I FINAL
FOR ALL INSPECTIONS (952) 447-9850
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