HomeMy WebLinkAboutBUILDING PERMIT #03-0574
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
5-/3-0~
I. White File I PERMIT NO. ():? ,c-"<14-
2. Pink City V --:::>
J. Yellow Applicant
(Please type or print and sig;n at bottom)
ADDRESS
to 647 fluJ t~c 1-.1.
ZONING (office use)
{215D
LEGAL DESCRIPTION (office use only)
LOT <.:3BLOCK ~ ADDITION
r()jitiaA1 rL IY (jfiA.; ~ J1.J:1. PID ()~- )=V)-{)O '(-9
if1l1' J71>1'
(Phone)
OWNER I
(Name) ,.,... Y {' .,..~ ""'-
6 6 'f? IlvJ I" c..
BUILDER V I ~
(Name) .../1-,-, (J (lie,.
(Contact Name) '--1-: ~ A ~, e 1:....
.
(Address) , 7 \- (, S ~"'" 1"-/ k.... ~ I,
/lJ~
(Address)
(Phone)
(Phone)
611," >O~,. J 71'1
P II. , ~....... L I'Y I-c-.
TYPE OF WORK
o New Construction
~k
o Fireplace
OPorch
ORe-Roofing
ORe-Siding
OLower Level Finish
OAddition
OAlteration
OUtility Connection
o Misc.
PROJECT COST IV ALUE (excluding land) $
Z. S-'() -
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
~terupon ~=e(;t::inSpectiOns. 2 \)I:J ), JC S!/-,/o;1
, Signature Contractor's License No. Date
I Permit Valuation ffZOot!J. DC I Park Support Fee # $
I Permit Fee $ '=A. zs I SAC # $
I Plan Check Fee $ itS, 0' I Water Meter Size 5/8"; I"; $
I State Surcharge $ 1.00 I Pressure Reducer $
I Penalty $ I City SAC and WAC # $
I Plumbing Permit Fee $ I Water Tower Fee # $
I Mechanical Permit Fee $ I Builder's Deposit $
I Sewer & Water Permit Fee $ lather $
I Gas Fireplace Permit Fee $ I TOTAL DUE dA-u..eo 5.1J .03 $ I /5, Z(p
./)
/; ff~f('.5
This Application Becomes Your Building Permit When Approved I Paid //~. ?-It:l . Recet>VNo.
~'1~ ~!L3/r; 3 I Date ~. J. OJ By LL-
0
~
Building Official 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 DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
S!TE ADDRESS ~~ ~ ReI
TYPE OF WORK ~~
USE OF BUILDING -5 F
PERMIT NO. 3 - ~ H. DATE ISSUED
BUILDER ])fA . rC\ PHONE #"J~. St>".~8t'J
NOTE: THIS IS NOT PERMIi-4=OR ANY OF THE INSPECTIONS BELOW
1X--""" ~ ~H_E~ERMIT IS j! SEPARATE DOCUMENT
4"'otJC- r~l~- INSPECTOR D~TE
I FOOnNG · I ~ VV~i~ I t4, !Z,'1 td3
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
J FRAMING I I j
FINAL I . ' . ~ (, f2J kJ3
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850