HomeMy WebLinkAboutBuilding Permit 03-0572
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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LEGAL DESCRIPTION (office use only)
LOT/&BLOCK / ADDITION
5.. 1.3, 03
I. White File I PERMIT NO I
2. Pink City .. O~ ~ 57 "')
3. Yellow Applicant . V 0--
ZONING (office use)
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OG~I'GL-O
PID25-370- (J16-0
OWNER~
(Name) ..J V "'- ""' F - '" :a. -\--.
(Address) \"1\)J. W~I\~4.""""c..').'"
4....
BUILDE~
(Name) V ...dl , 11-" \; ~; \< d..
(Contact Name) Yp,..\- ~ -(~J
(Address) \~ \, ""'\ ') A-~ -v
(Phone) '1 $""to . "1 LID -:) 11 j-
(Phone) 'l t.. Is S c;. fs" II , 0
(Phone) > ..---
TYPE OF WORK
o New Construction
ORe-Roofing
OLower Level Finish
~eck
ORe-Siding
OPorch
OAddition
o Alteration
OUtility Connection
PROJECT COST/VALUE (excluding land) S 1 (;00
o Fireplace
o Misc.
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
s~ pi m aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
el,\e\::;n to perform needed inspections.
X ~ LI Lf ~ C; S; - (). 0..3
Contractor's License No. Date
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 # $
Water Meter Size 5/S"; 1"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE ~,A I '&Y) 5_1 c} {Y2.. $ 138 ...6~
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I Rere-2JNoj/tf51/1J
By (;.
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
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~-- sd
ADDRESS
17 (3) wi /!~~t'$ 'Tv
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~-{7l
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION I)' II
I2!""'FINAL .(VTl.
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
I
LA (Xc
t:r~ ~
IWORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
D CORRE~ CALL FOR RElNSPECTION BEFORE COVEmNG
I -- J D--v?
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
_OTl
______________,_._.._,___..~.._. .__ _.._.__~~____._.,~.,____"___.,____,"._.._w,__'__"'__ ~__".__.._~..___._,"._".___ "0_- _ .
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECO D
SITE ADDRESS 33 -I. C!".~eSS T..".
TYPE OF WORK ~t..K.
USE OF BUILDING 5F
PERMIT NO. ~~i~7~ . D~TEISSUED .-II/-~
BUILDER D~~__ _ _I,~ PHONE#~"I(j
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
J FOOTING I JILil I S-- )IJ- tt).
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
~ I I
I FINAL I J/l;1/ I 5' ./ 3frU?
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
.
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