HomeMy WebLinkAboutBuilding Permit 03-0554
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~;.;:.
(J'lease ~ or orint and sUm at bottom)
ADDRESS
_l7no ,^~1ilJJ A-;~ ~,t;;.
LEGAL DESCRIPTION (office use only)
S- '] ~r:,/J. 'Ifl,
LOT BLOCK ADDITION
OWNER
(Name)
(Address)
BillLDER"
(Name) b.L. 1/-.).,.,.
(Contact Name) :!t.<'Siu P,,,..k.~
(Address) dO'El.D ~ c,l.<"j..
TYPE OF WORK
o Misc.
1. White File
2. Pink City
J. Yellow Applicant
(phone)
Date Rec' d
5...~"a3
I PERMIT NO. 03 -0554-1
ZONING (ofliceuse)
/L2-
PID 25- "/(1) -04-<, - 0
(Phone)
(Phone) 9s~'91S-1%/)1
I-e./u v,Vb.. . l11/v.<<lJW
D New ConsbUction
~Lower Level Finish
ODeck
OPorch
OAddition
OAlteration
ORe-Roofing
PROJECTCOST/VALUE (excluding land) $
o Fireplace
ORe-Siding
DUtility Connection
19 (,YO
I hereby certifY that I have furnished information on this application which is to the best of my knowledge b1Je and correct. I also certify that I am the owner or
authorized agent for the above-mentioned r-_wy'--J. 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 pennit for just cause. Furthermore, I hereby agree that the city official or a designee may
enterupon~er-_r""n,, perfo needed~' 'ons.
X ' J. I '
{A/, .:tlJlJ~S7 s- S- {)3
- Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Pennit Fee
I Gas Fireplace Pennit Fee
3,000,00
$ 7'17S'"
$ -
$ J"
/. U'
$
$ 4-0.00
$
$
$
This Application Becomes Your Building Permit When Approved
-'2_ . .
~ ;4 ..oJ.-
Building Official
5/1/a~
Date
I Park Support Fee
I SAC
I Water Meter SizeS/8"i I";
I Pressure Reducer
I City SAC and WAC
Water Tower Fee
Builder's Deposit
I Other
I TOTAL DUE
, ""C-
IlfrJl~~
7t'
I Paid
I Date
# . $
# $
$
$
# $
# $
$
$
$ //G. 25
~
I ReceiPt No. ijU,-"fd-JS
Bv /'r~.
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 aIIim, .::. .J (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
PRIOR LAKE
INSPECTION RECORD
/7..
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING
PERMIT NO.
CONTRACTOR PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPEC
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I j
I I j
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING If re ulred)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS \~ I,,~
,J) \f' () ,J-
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~}J ~
'~
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j
OCCUpy
I
UNTIL ABOVE
NOTICE
HAS BEEN SIGNED
\
This card must be posted near an electrical service cabinet prior to rough-In inspections
and maintained until ail Inspections have been approved. On buildings and additions
where no service cabinet is available, card shail be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850