HomeMy WebLinkAboutBuilding Permit 03-1279
DATE nilE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED lO-1-o~ 1D~0()
ADDRESS l.J'3U M~L~ ~~
OWNER CONTR.
PHONE NO. PERMIT NO. S .. (A"
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 ~~:E AIR TST
o SITE INSPECTION o MECH FINAL 11/ ~
COMMENTS: fj..... ~~~
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o WORK SATISFACTORY, PROCEED
)( CORRECT ACTION AND PROCEED
o COtJ/jR ORK, CALL FOR REINSPECTION BEFORE COVERING
Inspect r: Owner/Contr:
A .~ 447.1sS0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
C~~UlREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lliSltOn
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3 . Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
LJ31.1
~k<)c.d S ~
. I
LEGAL DESCRIPTION (office use onl~ '
LOT BLOCK ADDITIO~ ~Jrp...,.J"
Date Rec' d
PERMIT NO"3 - (l, l'
ZONING (office use)
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1;-2.
I
OWNER L/ ~
(Name) .77 ~'7 /7::.-e
(Address) A~ ~ r~e.f ,
.
(Phone)
(Phone) -6S7- 71.;>/-/0<::'9"
(Address)
TYPE OF WORK
o New Construction
ODeck
OPorch
ORe-Roofing
ORe-Siding
';>/1..... n::;. IJ.. <,,,. _ _ _ ...DLIl: Level Finish . Q Fireplace OAddition OAltera~n OUtility Connection
II"" fc...o..-vr ~"t-li511- t:> s:"'I'P/l..5SStN }' J e::; / /I &,(1'
b(Misc. FI.e6 Sl/P,l'/t6J.S I () 'j..J PROJECTCOST/VALUE (excluding land) $ /../ H V
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
=te~P7P~ons. 7- :7-07
Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
Plumbing Permit Fee
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
I Other
I TOTAL DUE
!1fltJ- -
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4?".c!>3
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Mechanical Permit Fee
I Sewer & Water Permit Fee
I Paid '(o)r~
I Date ~ .;...,
r 1i4'''''''' /
# $
# $
$
$
# $
# $
$
$
$ /fo.. /8
Receipt No. ~(Q 1..]
By .~ I1/f-
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, tax (952) 447.4245
16200 Eagle Creek Avenue Prior Lake, MN 55372