HomeMy WebLinkAboutBuilding Permit 03-1310
DATE nME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED /()-I ()-t/1
,
ADDRESS IC4tQ Py~---
,
OWNER CONTR.
PHONE NO. PERMIT NO. 7-151D
o FOOTING o PLUMBING RI o EXIGRADIFILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL 0
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ii'A'J7R REINSPECTION BEFORE COVERING
Inspector: -f Il- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
l!iS/iOn
(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
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Date Rec' d
q 2&.03
~. ~i~~e ~:;y I PERMIT NO. /\? ~ !''7/D
3. Yellow Applicaot C/ ...) .,j ,
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LEGAL DESCRIPTION (office use only)
LOT t BLOCK I ADDITION !JOlG4b7z.I;J I ji./C9
,
OWNER
(Name) S-t.ff Gt (" I S<l(\
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
o New Construction
OLower Level Finish
2~O
(Phone)
(Phone)
(Phone)
ODeck
DPorch
.
~e-ROOfing
OAlteration
o Fireplace
OAddition
ZONING (office use)
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PID Z.r: 023. 608. 0
(q (').) d00 --in {)'7::l
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
;teruPCwp<Oj~Yf~fi0'; nee d' s:7' q J;;" / 1
,/Si Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
PROJECT COST IV ALUE (excluding land) $
Z/Sl:>O. c..tV
$
$
$
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
Building Official
Date
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
Paid 7"'. (/1/
Date ?. 7/0 _0'7
"
# $
# $
$
$
# $
# $
$
$
$ 7fR. 00
f) I
w-o ~n
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 construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (95i) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372