HomeMy WebLinkAboutBuilding Permit 03-1395
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICAtE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/0./5.03
I. White File
2. Pink City
3. Yellow Applicant
PERMIT No.as-I3'1S-
(please type or print and sign at bottom)
ADDRESS
/(,5]> 4-
~~/,J
~
ZONING (office use)
t:-4--
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID~ 2/0.00 I. ()
OWNER
(N ame)
PE/VjVIN~ rorJ p~ ~NOOJ
(Phone)
(Address)
BUILDER L7 ~ () _ /
(Name) :::::>F~. ~ cg7l"" 'f ~ ~,Q (Phone) ~.r-_ ~ '? () --;? / It'
(Contact Name) L ~ (j I~ct .Z ~ C' A.J A-I2- (Phone)
R /' dO kJ ~?iI,- ~ t9u 'f--'Cr--
(Address)
~4 ()-O
L{~ Av~ .v
R -;r-cJ 2- 9-
OLower Level Finish
o Deck
o Fireplace
o Porch
OAddition
ORe-Roofing
OAlteration
~-Siding
OUtility Connection
TYPE OF WORK
o New Construction
o Misc.
PROJECT COST IV ALUE (excluding land) $
I hereby c . that~ha e 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
authori agent for th above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accor ce with
sub tted pI . I a aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a des' ee may
X ter UP~ ~perform needed inspections"" h-' /......- tl ~
( J Signature Contractor's License No. ~cui'
, - J
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $
I Permit Valuation
Permit Fee
Gas Fireplace Permit Fee
5;000.00
$ 1H,50
$
$
$
$
$
$
$
2.b ()
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Pc..uuit Fee
This Application Becomes Your Building P,.;..~t When Approved
Paid
Date
/52 ~ OV
/ I), /,j. OJ
R.~t!O"
BVO .
/52.00
~9f:J
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 for all inspections (952) 447-9850, tax (952) 441-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
ADDRESS
/ (p 5*3 L/
DATE TIllE
SCHEDULED ~ z: 00
~id,
CITY OF PRIOR LAKE
INSPECTION NonCE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
()3 -/J95
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
COMMENTS: ~ ~~ ~ jyL~ ; 4
1I1z, -,;J. 9() - 76 9& \.....J
et~~
~ WORK SATISFACTORY. PROCEED
/ ~ CORRECT ACTION AND PROCEED
o CORRECT ~ C~LL FOR REINSPECTION BEFORE COVERING
Inspector: ' ~ l Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
/NSNOTl