HomeMy WebLinkAboutBuilding Permit 03-0496
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
3. Yellow
File
City
Applicant
(Please type or orint and sign at bottom)
ADDRESS
17;(~9 IL~ /It L.w-/
LEGAL DESCRIPTION (office use only)
:).. 3 b!:dd
LOT BLOCK ADDITION
OWNER
(Name)
(Phone)
(Address)
Date Rec' d
4- -30 - cl3
I PERMIT NO. 03 - otf9(p I
I I
ZONING (office use)
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PID ZS-37Ci - {iSZ - 0
BUILDER-. .
(Name) Do~. J.I...-..I.u.. r;.."
(Contact Name) -(':'SS; t..L &~"-<
(Address) J,oSI,O K~~h,,'/.:L G..vJ
~
-Sft"Ve ~. .
(Phone) ~/;Z-J>~ r~
(Phone) 95;;1- 9JS- 7,!O?'
~" lu 1/, "j Ji" 111/.1 ..53VYY
TYPE OF WORK
ODeck
ORe-Roofing
OPorch
o New Construction
~ower Level Finish
o Fireplace
DAddition
DAlteration
o Misc.
h..iSh 3fi.t &i( i.. .&",,.,..'/PROJECTCOST/VALUE (exc1udingland) $ :21.5V
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 loca11aws 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 p~peffY ~ Yfrform needed hns]!ctions.
X >Iv _~~ . It 1.1Z: ';lPQ57,S 7 'T'-;;9-0I
SIgnature Contractor's License No. Date
I Permit Valuation /1 000. 0 (') I Park Support Fee
I Permit Fee $ 34.'75 I SAC
I Plan Check Fee $ - I Water Meter Size 5/8"; 1";
I State Surcharge $ .50 I Pressure Reducer
1 Penalty $ I City SAC and WAC
I Plumbing Permit Fee $ 1/d,N I Water Tower Fee
I Mechanical Permit Fee $ I Builder's Deposit
\ Sewer & Water Permit Fee $ 1 Other
I Gas Fireplace Permit Fee $ I TOTAL DUE
This Application Becomes Your Building Permit When Approved
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Paid
Date
Building Official
Date
# $
# $
$
$
# $
# $
$
$
$ 75. 25
ReceiotNo. i-,Yi!;;;O
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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 notiee for all iospections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
DATE
SCHEDULED ...2/U~"'"
/7..hJ-? .&., yr" tfi j
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~~NSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o ..3EWER HOOKUP
~~UMBING FINAL
....,.-.,ECH FINAL
CQDIIItENA: I ,/ / /
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TIME
03 - ~7'
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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AORK SATISFACTOR;;;OCEED
/& ~ORRECT ACTION AND PROCEED
o CORRECT WO~~~~R REINSPECT/ON BEFORE COVERING
Inspector: y~ L-- OWner/Contr:
---
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH" SAFETY/