HomeMy WebLinkAboutBuilding Permit 03-1273
. . v~ PRIOR V./(E
INSPECT/ON NOTICE
ADDRESS
SCHEOUlE:D
COMMENTS:
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OWNER
----- - CONTR
PHONE NO. ______ .
----- PERMIT NO.
o FOOTING ____
o FOUNDA TION 0 PLUMBING RI
o FRAMING 0 MECH Rt
o INSULATION 0 WA TE~ HOOKUP
o FINAL 0 SeweR Hoo/(Up
o SITE INSPECTION 0 PLUMBING FINAL
o MECH FINAL
- J,..,
~tE TIME
q-4"'C"l
~---
~7'
o EXiGRADlF/LLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE A/~ TST
0----.:
==----==
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~/( SA TISFACTORY, PROCEEO
1i1>'e0R~ECT ACTION AND PROCEEO
o CORRECT /(
, ':J F~~;EINSPECTlON BEFO~E COlrERING
InSPector: {'~-CO
Owner/COotr- --------
.." "'- '''' "" "", "''''''' . -- - --------
CODE IlEQ{JfilErlfEN ON 24 HOURS IN ADlrANCE.
7:s AilE FOIl YO{JIl PEfiSONA./. Ifp _. ~b _
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Date Rec'd
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I PERMIT NO'03-10l13l
I. White
2. Pink
3, Yellow
File
City
Applicant
(Please ~e or print and sign at bottom)
ADDRESS
ZONING (office use)
)539/- Red ~5 ~d
LEGAL DESCRIPTION (office use only) /i ..--I., (),}
LOTOZELOCK / ADDITIONr~t!jj' ~~
OWNER
(Name) W" J I) f'r vV1 yytA- c.. 1J D tJ A I cJ
PID';?S-(Yj j-OOJ--{.)
(Phone) q.s.J. t.J lJ") I.J q il")
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
~e-Roofing
DRe.Siding
OUtility Connection
DPorch
DAddition
DDeck
o New Construction
TYPE OF WORK
DAlteration
o Fireplace
DLower Level Finish
PROJECT COST IV ALUE (excluding land) S
o Misc.
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 Z~:\can revoke this pennit for just cause. Funhennore, I hereby agree that the city official or a designee may
:te;;~to~nik~Q j-J9-t?3
Signature Contractor's License No. Date
$
$
$
$
$
$
$
$
$
#
#
I Park Support Fee
I SAC
\ Water Meter Size 5/8"; 1 ";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
\ Builder's Deposit
I Other
I TOTAL DUE
;:J5CO, --
- 7i/-16
I ' c;.5
I Permit Valuation
I Permit Pee
I Plan Check Fee
\ State Surcharge
I Penalty
I Plumbing Permit Pee
I Mechanical Permit Fee
1 Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
#
#
~
'1 h -----
I Receipt No. 4537 (
By U~
o
J
-;0.'~
a~/4-5
;
I Paid
I Date
This Application Becomes Your Building Permit When Approved
Date
Building Official
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 .~".i"~'''''J Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
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
Planning Director