HomeMy WebLinkAboutBuilding Permit 03-0565
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICAtE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
S.ll.OJ
L White File
2, Pink City
3 . Yellow Applicant
PERMITNO. 03---- 5lof
(Please type or print and si{tIl at bottom)
ADDRESS
"2 70 LAJ~r ~ /
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDZS- oS-I-OOI- O.
OWNER
(N ame)
(Phone)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
K.t.u rrz...\ ~Ob~ C:O/J.:=t,t...4 d IO~
~I\J ~iW...EJ\ b rL.. ~
. - -
1(.,02,...0 51 F(l.A-JJ c...I ~ LJ...J P n.. 1 () fL
(Phone)
(Phone)
LA Ie.. fi.. P1 v 5 ~ 372...
q~-z -L/47 -/832
OAddition
~-ROOfing
o Alteration
ORe-Siding
TYPE OF WORK
o New Construction
ODed
o Porch
OLower Level Finish
o Fireplace
OUtility Connection
o Misc.
PROJECT COST IV ALUE (excluding land) $
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 th~rty, ~ern~rm ~ded. inspections.
X .f AI\ !'7 ../ b. 1",- 03
Signature Contractor's License No. Date
I Permit Valuation -z.. ....$ u 0.... dO Park Support Fee # $
Permit Fee $ "I 7t./. 1 J"'- SAC # $
Plan Check Fee $ Water Meter Size 5/8"; 1"; $
".-
$ 1'-- Pressure Reducer $
~[.,.a
$ City SAC and WAC # $
$ Water Tower Fee # $
$ Builder's Deposit $
$ OOa $
$ TOTAL DUE $7('.~
/1
. ~~. ~ub
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Pc.uuit Fee
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When At't'A'" ..ed
Paid ~'or u;J
Date r. /7... ., () 7
Building Official
Date
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 tor all inspections (952) 447-9850, tax (952) 441-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECnON NOTICE
DATE nile
SCHEDULED
~-/2-
ADDRESS
4-270 LO~ b//U5S/
OWNER
CONTR.
PHONE NO.
PERMIT NO.
3-S~S-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
X FINAL A!JJDr
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
ftlo
~rJ)~
)
Ov~
~WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORR1!:oET . ::ALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
-7
CAt -9fO FOR THE NEXT INSPECnON 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl