HomeMy WebLinkAboutBuilding Permit 03-1234
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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I. White File
2. Pink City
3. Yellow Applicant
(Please type or print and siJtll at bottom)
ADDRESS z{} A/ A./l n:1
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Name)
Selct R..oof- rl-1 ~
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(Phone) hI'). -~). ~ -80l.( ~
(Phone)
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,
(Contact Name)
(Address)
TYPE OF WORK
)f(Re-ROOfing
DAlteration
D New Construction
DDeck
DPorch
DAddition
DLower Level Finish
D Fireplace
D Misc.
PROJECf COST IV ALUE (excluding land) $
Date Rec' d
PERMIT NO(jj,.. /231--
ZONING (office use)
/II
PIDZ5: 9Z8. (J 12,.. .7
ORe-Siding
DUtility 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
;terupontheP~r~~:' /O~ 0 Cj-(6- 3
Signature \. Contractor's License No. Date
I Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Park Support Fee
SAC
$
$
$
$
$
$
$
$
Water Meter Size 5/8"; I";
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
Plumbing P,:,ullit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
TOTAL DUE
This Application Becomes Your Building Permit When Approved
I Paid
I Date
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9_/(, .I))
Building Official
Date
# $
# $
$
$
# $
# $
$
$
$ 1{p. cJ 0
11
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By ,
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) 447-985(), tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
DATE TIllE
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
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SCHEDULED ~~ ~
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Z:8d
OWNER
CONTR.
PHONE NO.
PERMIT NO.
-LJ~ -jZ.!J 'f
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
r D' SITE INSPECTI
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
VNl.LT w / ~
I
~~
~WORK SATISFACTORY. PROCEED
b "CORRECT ACTION AND PROCEED
o CORRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
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Inspedor: ( .....1 " Owner/Contr:
CALL 447-9850 FOR: THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOn