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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/0-/7-0/
~. ~:~e ~!:y I PERMIT NO. 0/- /llD ]
J. Yellow Applicant . _ _ _
c
f)ri, U'f Lo-k,
'Ss 37~
!y\,V
~.
<.....Jh
. ""e S-e
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
ZONING (office use)
/?/SD
OWNER
(Name)
.J eN IV /1"("'-)
y- -.Je /\A .k-or
Z '10 - :3 7.j
<9 S-~ - LI '-f -7 ~ d' / 7 c.)
(Address)
^. e s.-e.
N-c.
.,
Let},'t..l!
m/V STs7<.....
BUILDER
(Name)
(Contact Name)
(Address)
...S e (+-
(Phone)
(Phone)
q Jd- - lo( '-( '7 - 8- /?d
o New Construction
TYPE OF WORK
ODeck
ORe-Roofing
ORe-Siding
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 property to perform need inspections.
;) , J
. . ,'/\/CL"L/l
OPorch
&ddition
OLower Level Finish
o Fireplace
OAlteration
o Misc.
PROJECT COST IV ALUE (excluding land) $ <-20 6 U U
/
x
Water Meter Size 5/8"; l";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
Permit Valuation
1'/ r4-
Contractor's License No.
Park Support Fee
SAC
#
#
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
OUtiIity Connection
/0- /7 - 0/
Date
$
$
$
$
$
$
$
$
TOTAL DUE C!A-
~1f- fro ~ I
,
omes Your Building Permit When Approved
I Paid
Date
IrJ-:). ~-~tJl
Date
This is to certity 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
~~s~een signed by the t~ Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
~. ~---~ lct:~-l/r~ ~v ~~1 ~"n-Jl~~s
( pr~l"g Dlre'tn, Dol' S''',. C<mditi,m, ,rMy
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
~..--
'-k_~""...,.,.".".,...,.
White - Building
Canary. en9irneri '
Pink - Planning
Thr Crn'e-r olChe- t.kr ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT STEW A g I
APPLICATION RECEiVED I () - 1/ - 0 I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
0779:; DENESE ~I NE:
Accepted )( , Accep~~,<f With Corr~.9tions
Denied
Reviewed By:
4/i;"g
Date: IO~Lj-o/
Comments: See Reverse :'lidflfQr. J!.dWtionaJ .IOformatioQ! . !
~
. I
~
~
~
.~
See Attachments: 1) Grading Plan, 2) Erosion Control Mea'sures
· / " 3) FrosiOli'Conlrol PI;:m
~
,.~:
"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. II
11'V1
White - Building
Canary . Engineering
Pink - Planning
Tht" C"t'nft"f or Iht" I..h Counlr,"
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT S~W A R ,
APPLICATION RECEIVED I b -If - 0 J
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
077~ D5N5S5 ~I NG
Accepted ~
Accepted With Corrections X
Denied --T-37;;) /
Reviewed By: {;;:::.;;~&--:.
Comments:
All ('-OVls~h.Jc,h'OYI ~hOJ.l C'O'lNIp~_ With_~ ~O(JO
e~~,
Date: /0 -Q0-(){
"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."
The ('en fer of rhe tab Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
,...,~-_.
! i.-'~ ; \ / \, '
L_""' ~. Iw; 1 '-.....
~I /
I - \./
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,- . /,,,
/ / (~
i,.
I. .,/' '-' , '.~ t__
t..
.~..-'
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, .... L---
Accepted ~
Accepted With Corrections
"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."
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e2s:ao 10 61 ~~O
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS (o ~ ~ E!) [')p,^ t"'~ ~ ~ ="= .
NATURE OF WORK ~ .
USE OF BUILDING ~W
~~~~~A~$OR ~~:~r/12 DATE ISSUEDpH~~~(.3~~~_8{,)6
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING
FOUNDATION (Prior to Backfill)
PLACE NO CONCRETE UNTIL ABOVE HAS BEE
ROUGH - INS
INSPECTOR
DATE
I
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
J 1
FINALS
GRADING (Prior to Sodding) ~ / /~ ol7
BUILDING --.-
ELECTRICAL
PLUMBING
HEATING
1
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shaH be~laced near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850