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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
5-- ZZ -02-
I. White File I PERMIT NO
2 Pink City . 02 - /)/ 1'13
3. Yellow Applicant . V~V
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
ZONING (office use)
C3
PID 25-00/-
OWNER
(Name) nrKc n.<.lL 6 i IS ~
(Address)
-:::Sa. IYLL
(Phone)
BUILDER
(Name) ~I::::+(~ n l-h mp \ 1n L _
I
(Contact Name) ::5:\ \ L~i Sc.h Vl1, I ~ ~
(Address) VtOi 0 CD lYll\l<,-rcZ At-e... ,,1 C It 3cu
(Phone) 9 5J- -LtIfG :-J (,c=l Y
(Phone)
TYPE OF WORK
o New Construction
o Deck OPorch ORe-Roofing ORe-Siding
P-HO
o Fireplace OAddition )iQAlteration W~Li- OUtility Connection
. - -~~-"
PROJECT COST IV AL UE (excluding land) $ _ .., .
OLower Level Finish
o Misc.
I hereby certity that I have furnished information on this application which is to the best of my knowledge true and correct. I also certity 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 u n the property to perform needed inspections.
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
$
$
$
$
$
$
$
$
es Your Building Permit When Approved
5=-2 1- 62-
Date
$
$
$
$
$
$
$
$
$.39. ?
1~~/-fz/tJ7
l tto1
Contractor's License No.
Park Support Fee
SAC
#
#
5-d~-O.:?-
Date
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
#
#
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
I Paid 3lZ ~
Date _"},a/tI 2_
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
White - Building
Canary - Engineering
Pink - Planning
-
The Crnlf'f of rh.. I.ah ('OU"'..,.
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
BAKK:.-6N 1t0116S~
6-- 2 Z- ~() 2-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
4-7'92- OAK-Om ~ S6
Accepted ~
Accepted With Corrections
Denied ~/J A? A
Reviewed B~ f/ Jl
Comments:
Date:
~-2 i-o~
"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."
--
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS -.!1!J52.. Da ko~
TYPE OF WORK ((~ W~ d- ~vL.
USE OF BUILDING C~v-.- .
PERMIT NO. {}z -{) (i, 03
BUILDER 3Q~t<~ ~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
DATE ISSUED
5"' - 2 <.{ --cry
INSPECTOR
DATE
I
I
,
I FINAL
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
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