HomeMy WebLinkAboutBldg Permit 04-0513
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
PERMIT NO. ()I/- 5/ 5
(Please type or print and si~ at bottom)
ADDRESS
'S J...~S ~ fru[e 7ftX-'ler
LEGAL DESCRIPTION (office use only) 0 ~ ~
LOS BLOCKb ADDITION~
OWNER D 'If If)
(Name) to-' , I
(Address) S I-i_.
-, I
l!Jfl~
ZONING (office use)
e,5D
Jifp
PID ~~.,. //}~-O<;("-o
q ~2 041.33 c{;-
(Phone)
BUILDER
(N ame)
(Contact Name)
(Address)
SELA ROOFING & REMODELING, INC.
41 00 EXCEl S;IOR ~I \/n
ST. LOUIS PARK, MN 55416
fD JMJUl UOU
(Ph~'f t(:L3 <((}L1~
(Phrilf 2- q 07 'i; r;z5'-
TYPE OF WORK
o Misc.
. ~ ..
o Deck o Porch ~ROOfing ~-Siding
o Fireplace DAddition o Alteration DUtility Connection
PROJECTCOST/VALUE (excluding land) $ ..2.1 !(10
o New Construction
DLower Level Finish
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
:leruponthe~;;~~ns (~ 2 7- G{
~ U Signature Contractor's License No. Vale
I Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
d~CJ. ----
$ -1L/,75
$ /~ if,&)
$
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
Building Official
Date
I Park Support Fee
SAC
Other
$
$
$
$
$
$
$
$
$ I/(P .:--::-
). _____. k i" {?' /" 1 /\
, (".r _ / Receipt No. Lf0D Lf U
. ct /" ;:;/. 'j-L; By /" fj.
- - )' ~ ~
#
#
Water Meter
Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
#
Water Tower Fee
#
Builder's Deposit
TOTAL DUE
I Paid
I 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, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
~{#
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ADDRESS
cYss-
-Y/ Uc e..
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o~- 0/5
o FOOTING 0 PLUMBING RI 0 EXIGRADIFILLlNG
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
~AL 0 PLUMBING FINAL 0 GASLlNE AIR TST
D SITE INSPECTION D M"FINAL. ,r;
COMMENTS: ~rCJof/ ::r- (i!!?,n~p
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~RK SATISFACTORY, PROCEED
. D CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FO REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNon