HomeMy WebLinkAboutBuilding 02-1350
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(' >J f' lvJI e
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
N\l).{\ ~n.'\
CkH It ~
G '\ e!'+sr (\ Co (Y'f Vlf\ Y
(Contact Name) ~ /\ (\\e. \.5, ~/-
(Address) ~\r l Ie ~LfoD
r,-et\t
(Address)
10
Tee... \
BUILDER
(N ame)
TYPE OF WORK
o New Construction
OLower Level Finish
Misc.
(-:..... ,I' \.. -,
..-\,.,. . ~
I. - .
0' I i.f.J
Date Rec' d
1. White File
2_ Pink City
3. Yellow Applicant
$ .;)<}/j
/11 _L
PERMIT NO. Ol-
'S;~] if
PID
(Phone) 61") - (1]4 --
9S)_'N7-
763b Ct{(
bS:n ;-/
(Phone)
(Phone)
fl
I
ODeck
o Porch
ORe-Roofing
ORe-Siding
o Fireplace
OAddition
OAlteration
OUtility Connection
. "~-_(()\\i~"J" PROJECTCOST/VALUE (excluding land) $
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 prorerty to perform needed)nspections.
X 5-tt'vl.l \X (2 _~ fY\ Nfl-I 7 ~ 6
Signature
Permit Valuation
Contractor's License No.
10 Iq~Yj
I ate
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
~~ ~I--
Building Official
/4Aylo z.,-
,
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ ZoCJ,G.t-
Paid
Date
2-09. ~ (p
JO./~ -02-
I ~;ceJil- +3;W!
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 consttuction to commence. Before occupancy, a Certificate of Occupancy must be
issub . '2. r"11 ~ ~ ' J-
~<tw?' -L' ~- Idll~fte; A.#o"g ~ d.b~..Jd:i..-
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
Tht' Ct'nlt'r nf tht' Lllkt COUnlr)'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT (~; e v-r-SeAJ ('i).,
APPLICATION RECEIVED 10-9- 0 if-
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is propose at..;.",
L;-fl () I ); ~
/'
Accepted
Accepted With Corrections
Denied
,.
Reviewed By: ~ i4'.... tfJ-; Date:
Comments: ~,~ ~~ ~
'1 .A;--~ ~r~'
/(J/t cf (B l--
~ .,7t-ry ~.
"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 4810 ~ <<~1f'U.I'- LI"-~':L;N IP-.
TYPE OF WORK ~~ lJ __t.nI
USE OF BUILDING S. R A.
PERMIT NO. 0 Z - /3::;u DATE ISSUED ....Jo.l.B (0..... ~
BUILDER b'U+Se-N c.~p~~ PHONE #qS2.-f.("f7-b~<f7~NQ,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~ ~ "'l'V'-~ ~p6clL INSPECTOR DATE
~O'~ ~~~~) Lv\r(I to/),.l
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I FRAMING {~ ~ ~ ~ flokJ ~ , It/lL/E'7-
'FINAL ~ ~I I
Call between 8:00 and 9:00 A.M. for all inspections
DEPARTMENT OF
BUILDING AND INSPECTION
FOR ALL INSPECTIONS (952) 447-9850