HomeMy WebLinkAboutBuilding 03-1083
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I PERMIT NO. 03 - 1t18'~
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White File
2_ Pink City
3. Yellow Applicant
ADDRESS
Z.~?3 ""'5~rfA1H Nw
LEGAL DESCRIPTION (office use only)
LOT ~LOCK , ADDITION
adtJvJ
Date Rec' d
ZONING (office use)
;;L-
~
OWNER
(Name) c::srmT ('~OtJO
(Phone) ~l7- 'li:JZ ~73,)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
eck
OPorch
ORe-Roofing
ORe-Siding
OLower Level Finish
o Fireplace
DAddition
DAlteration
o Misc.
PROJECT COST IV ALUE (excluding land) $
OUtility Connection
1 hereby certifY that 1 have furnished information on this application which is to the best of my knowledge true and correct. 1 also certifY that 1 am the owner or
authoriz 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
submi d lans. am a:w that the buil' official can revoke this permit for just cause. Furthermore, 1 hereby agree that the city official or a designee may
enter p the rty; erform neede . spections. f') I /63
Contractor's License No. 'f- ~ Date
Park Support Fee
SAC
#
#
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
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
~~ r?j(?~3
Building Official Date
$
$
$
$
$
$
$
$
$
,'1/P
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
RECORD
SITEADDRESS ~3S3~ .-ift>.Nf:r.re.sf p~-H..
TYPE OF WORK ~t:..1<
USE OF BUILDING
" PERMIT NO. l>3 - ~ DATE ISSUED
BUILDER ruut,.o. PHONE #&(l.-d.-~~ - 3735
NOTE: THIS IS NOT PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
. INSPECTOR DATE
I FOOTING W / L r 4/.t-- I ~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
--"" FRAMING ~ c..w~~ I I
c ~ 1)u.I<- &/tJeos A1eE J4a0l'Ue1J
I RNAL I I
FOR ALL INSPECTIONS (952) 447-9850
I
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