HomeMy WebLinkAboutBuilding Permit 04-0266
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICAtE OF ZONING COMPLIANCE
AND-UTILITY CONNECTION PERMIt
I. White File
2. Pink City
3 . Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
t;~()7 Itytj!t/0
LEGAL DESCRIPTION (office use only)
LOTLf BLOCK (ADDITION L~J de.-
OWNER
(Name)
(Address)
BUILDER
(N ame)
(Contact Name)
(Address)
TYPE OF WORK
::::-.
o Misc.
(
C,I Y'LL ~ <e-
o New Construction
!lilt) IJO Y'
PERMIT NO. ?tf- ~ <9 ~
ZONING (office use)
Je )gO
PID ~5- /'1 .~ ~ ~ (JCJ 4- {)
(Phone) tJ( '5 Z. tIjJJ / &!5dJ
<e
(phone) ~ 12_ 'KZ2> - 1'(0 &i ~
(PhOne)M- 2. q 0" 7i'U
OLower Level Finish
o Deck OPorch ORe-Roofing ORe-Siding
~eplace OAddition o Alteration OUtility Connection
PROJECT COST IV ALUE (excluding land) $ S U 00 - 00
~ .
I hereby certifY that I have furnished infvuuation on this application which is to the best of my knowledge true and correct. I also certifY that I am the owner or I
authorized agent for the above-mentioned property and that all construction will conform to all existing state and 10ca1laws 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.
X ~~~./'f
(/ Signature - Contractor's License No. Date
(
Jo(4//e- ff11.Jrf>>l)
~ 30 7 /.L-;11 ~V; 0 /('~ I -&--
SELA ROOFIN~ & REMODaINB, .,.;.
4100 EXCELSIOR BLVD.
ST. LOUIS PARK, MN55418
1019001050
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
.l:~renalty
:;l'lumbing Permit Fee
)' Mechanical Permit Fee
/" .. Sewer & Water Pc.uuit Fee
Gas Fireplace Permit Fee
;:)500..--' _
$ 7lj.70-
$ /"~5
$
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
Building Official
Date
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid
Date
11 .-~
!f- IS" -(1 Lj
. r
# $
# $
$
$
# $
# $
$
$
$ ?t.. --
. ~ ..---.
Receipt No. '-lIP Lf ~ ~
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 I 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) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
DATE nME
CITY OF PRIOR LAKE
INSPECTION NonCE
SCHEDULED
~:t utI
\
ADDRESS
~};(J --,
t,-e c-1t /~ .~
f
CONTR.
OWNER
PHONE NO.
PERMIT NO.
Lf-l-CC
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o 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 RNAL
o GASLlNE AIR TST
o
COMMENTS:
C~( y'J1 ~I
I
~ ~-.~
/ r v---f ')
/ ;/ I/Jk- fIle /J
\ ~'\-<'-/ - ~
"--- ~
~ SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W:R~ #" FOR REINSPECTlON BEFORE COVERING
Inspector: 1.lL( Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
lN8NOn