HomeMy WebLinkAboutBuilding Permit 03-0405
?9-1.3/
(Please type or print and sign at bottom)
ADDRESS
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
~""1-03
1/ I eAV.e'l1-l
I. White File
2. Pink City
3. Yellow Applicant
c-v/Ct/6
LEGAL DESCRU'TlON (office use only)
LOT / BLOCK I ADDITION 6f::M:o / )..//1(....- ?/ 04(;:/ 4- W
OWNER
(Name)
CTll50IJ /fIJO ~tlL3/N ..sOK.OLOSK.I
S/l/"1C
(Phone)
(Address)
o Misc.
PERMIT NO.03 -. 04-0S
ZONING (office use)
f/U SD
PID 25- 322 -001- tJ
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2-Z& - ~
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(Phone) fs;:J. -*10 ..-#6 3
(Phone)dd.2-.~ 8C3Q
IYl N S~~7'?-
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OPorch
ORe-Roofing
OAddition
OAlteration
ORe-Siding
OUtility Connection
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
;ter ~p.~ ~~ pr e to.:e~m ne ~~ lr 'd ~ 0 ~
Signature Contractor's License No. Date -
BUILDER'; 1_ J J I "JA J J f)f}
(N ame) /J..}{J./f/l. 1'[" (JJ{.JJ1.{M.X'X
(Contact Name)
(Address) 18So/ ~lJ--Vv.J,:i ~/J./Y-e5 Ct~r
TYPE OF WORK 0 New Construction ~eck
OLower Level Finish 0 Fireplace
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
PROJECT COST IV ALUE (excluding land) $
$
$
$
$
$
$
$
$
?u(J() 0 frO
[(3 J.-j
~y "
/fO
This 1:. Ii li,c:atinejmes Your Building Permit When Approved
r fWlt.1 ~ L-f" (O~07
Buildit<g Official Date
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
Other
TOTAL DUE
I Paid /5 i. J'';'
I Date 4-...; tJ .. (!J
#
#
#
#
$
$
$
$
$
$
$
$
$
11r 8'{,
ReceiuiNo.q 4'Wf
By /
C
. 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 I'f llanner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued./kl p~ Lfll)-cfl rle'l2 ~ Dtd<: lf~",clt?o+-
. 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
SCHEDULED
ADDRESS
If. 31 ^
IJ rc .frJY r II
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION/) A
c!I FINAL 1../-( c., t..-
O SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
-
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----
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'---- --
DATE TIME
6-/?
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: VI;(? C:. - 11"r d) Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
""
PRIOR LAKE
INSPECTION
RE~ORD
/~ ~~.&'A ~
DEPARTMENT OF
BUILDING AND INSPECTION
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
FOOTING I !II~ I 4~ /7- 0::,
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
:~ I I
J FINAL
,...
lllV./ (fJ; 1'1~OY
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
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