HomeMy WebLinkAboutBuilding Permit 03-0474
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICAtE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White File
2. Pink City
3. Yellow Applicant
Date Rec' d
ef'. ~~(I J
PERMIT NOOJ-01-74--
(Please type or print and sign at bottom)
ADDRESS
5(P7~ 6f:;,LJ/I~OOO Sf, Ale
LEGAL DESCRIPTION (office use only)
LOT /hLOCK / ADDITION ~1tIL) ~/. ~ /H
ZONING (office use)
PID25'"- 239- () 14-- 0
OWNER
(Name)
(Address)
(Phone)
BUILDER
(Name)
(Contact Name)
(Address)
\L~dJ t=fz-\ U)6r;...~ ( L)I.JS"-.
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Ilco7~o s,- 1="'fLA-JJc.,.S ~
(Phone) C, S z... - "" 7- 1952-
(Phone)
fa., ;) cL. ~JLL- f1JJ bS 372..
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 property to perform needed inspections.
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S-ignatur~ r
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Building Official Date
This is to certifY that the request in the above application and accompanying documents is in accordance with the City Zoning Onfuumce ~ 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.
TYPE OF WORK
o New Construction
ODeck
OPorch
J:2'e- Roofing
o Alteration
OLower Level Finish
o Fireplace
o Addition
o Misc.
PROJECT COST IV ALUE (excluding land) $
x
Contractor's License No.
P':'H1.it Valuation
Park Support Fee
#
Pc.uuit Fee
SAC
#
Plan Check Fee
Water Meter
Size 5/8"; 1";
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
/orJ/
, -
Pressure Reducer
I City SAC and WAC
Water Tower Fee
#
#
Builder's Deposit
Sewer & Water Permit Fee
Other
Gas Fireplace Permit Fee
I TOTAL DUE
Paid r& ~~
Date ~- vi -t..
This Application Becomes Your Building Permit When A....~ .../ed
Planning Director
Date Special Conditions, if any
24 hour notice tor all inspections (952) 447-985(), tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
ORe-Siding
OUtillty Connection
4-1-'-1- 03
Date
DATE nile
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
6ft:, 78 C6J:;A/2M/OOO S I .
OWNER
CONTR.
PHONE NO.
PERMIT NO.
3.474-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL UtJ P
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
~t\~ - t:JO Ncr~
"rJIwgRK SATISFACTORY. PROCEED
~ ~ORRECT ACTION AND PROCEED
o CORRE RK. CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
QUlREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
L .11I '" ~ .