HomeMy WebLinkAboutBldg Permit #03-1605
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ADDRESS
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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LEGAL DESCRIPTION (office use only)
LOT d- BLOCK d..-... ADDITION
OWNER
(Name)
I. White File
2. Pink City
3. Y cllow Applicant
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(Address)
BUILDER ("'~ u_
(N ame) tvt)'Y'A'IY
(Contact Name)
(Address) \.4",t Du
TYPE OF WORK
o Misc.
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Date Rec' d
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PERMIT NO. 03../~5
ZONING (office use)
121
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(Phone) CJ ~2 - 32-1 - ~Pl b ~
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L-Vl I
(Phone) q~'2- - 4...1-0 -- 11 ~l)
(Phone)
o New Construction
~~eck
.ID~ce
ORe-Roofing
OLower Level Finish
OPorch
DAddition
OAlteration
PROJECT COST/VALUE (excluding land) S
ORe-Siding
OUtility Connection
4.r:.bD
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
enter upon the ,r;werty to perfo e d inspections.
X ~{I j -2D2\I.v\lu
, Signature ~
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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
,;; 4 '9'0, Q'C)
$ I 1f1. 'Z-s
$ ~3.ZI
$ 2. DO
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
~~
Building Official
/H;;>S /03
f Date -
Contractor's License No.
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
I Paid
I Date
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12- }lV}C~
Date -
# $
# $
$
$
# $
# $
$
$
$ /~2.. 4-~
Receipt~o. 4-(, UJ .t-
By "1-
0
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
..
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS ---.S 00 f' P ovds E4e.. t.~
TYPE OF WORK D:e.c.,~
USE OF BUILDING ~~T=
PERMIT NO. .tJ3, /(POS ~ATE ISSUED
BUILDER F I'DN+i,-, ~ PHONE # 41/0-- 77S!J
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING
PLACE
I LlVI;? I I . I L(-O'-'I
o CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I I
,(/ all/7 I / - 2-C-OLI
.I
I FINAL
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
S-aJ'8- f{;-V1cJS~~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION /L 1/
~AL f/t't-I'-
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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"---
DATE TIME
-./:- ~ -Qt.1
,
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
---
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---------
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT "~R REINSPECTION BEFORE COVERING
Inspector: .f!..--lf Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl