HomeMy WebLinkAboutBuilding Permit 03-0516
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File I PERMIT NO
2, Pink City o()2_ c:"/'
3, Yellow Applicant J -.....J j b
(Please type or print and sign at bottom)
ADDRESS
~/SDoffice use)
ill! '-I-ch-t?~1 / (] / \--
/5t:, 9~
LEGAL DESCRIPTION (office use only)
LOT I6iLOCK ~ ADDITION ~ Pt7J?cL
PID ;?S- /S-S-- Ol/J~()
OWNER
(Name)
SV\\ ~ ttt
''""'"''I
_".ONi\\t\I\N
45)- ifFJ- (jqln
(Phone)
(Address)
'Ai u8A- A' I 5 ",AA '
'V~i",^* 1 ^' C:.. ' ,(lCJ-.~~L= ML. ~ PI ~l-to (Phone)
,fr, 8 ~lo('Ltv~ (Phone)
k:t.J&<"> WcuO (2ot\fJ t;'.,,~ MN
BUILDER 0 J S
(Name) If-
,
c;,s- I -1'9 ({ - % 8 1-
6 j) - lu7- ,,~~~
SS'd-d.-
(Contact Name)
(Address) j <..f (8
~k
TYPE OF WORK
o New Construction
OPorch
ORe-Roofing
DAlteration
ORe-Siding
DUtility Connection
o Lower Level Finish
o Fireplace
o Addition
PROJECT COST IV ALUE (excluding land) $ '7 I i.,) 6 (:)
o Mise,
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 plan,S',,' I am~a ~at e building official can revoke this permit for just cause, F, urthermore, I hereby agree that the city official or a designee may
enter upon the :~ope!'::n t pe . needed inspections, d G J 1 7 j" J
X Ii f-V j , (lJf.. -J- oJ 1/ (7 S- I 03
f Signh6re V Contractor's License No. Date
iildo{J, 00
$ '7 7. ~s
$ t,g.21
$ Z.o 0
$
$
$
$
$
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
$
$
$
$
$
$
$
$
$
#
#
#
#
'fD 2.4fo
17
. ReceiMNo. ~ ~
Bv/l-,
o
I Paid
I Date
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&:/-0'1
r
This Application Becomes Your Building Permit When Approved
~~~~1a3
Building Official ' , Date
is 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
'n 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
'd.
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
//;?q7
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION /L. (
?'FINAL ,~L/l
o SITE INSPECTION
COMMENTS:
/
/
(/
SCHEDULED
/l'VL,cht! I I' _Iv-
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
r
I .,
I !)~C
l V
f'
r,'
DAT~
{,~( t
7- ~ / L
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
I
LR
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: f1r4 (; - ( (, - d? Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS IS,-!/? A1,'-hJJ ~II (l"j",.,.
TYPE OF WORK O~/C
USE OF BUILDING SF
PERMIT NO. 0 .. 51t.... DATE ISSUED !j--II-O ~ .
BUILDER U~c..t. PHONE~~ '7J,.'S-3'--.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
J FOOTING I M/ I S<I]-d;J
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
---- I I J
f FINAL
-
JM(/ ror(t,-03
Ii
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850