HomeMy WebLinkAboutBldg Permit 03-0483
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ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3 . Yellow Applicant
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LEGAL DESCRIPTION (office use only)
LOT I BLOCK I ADDITION JOHtlSOtJS /lOW 0
OWNER
(Name)
Gt&~N 6R.U.:5S/NG
, I{I
/ f)!5 J.I.5 .L aKP,Vie.w l.J~\~
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
Date Rec' d
PERMIT NOoJ'3_ L/83
ZONING (office use)
/<? /.5.0
PID LJ:)- /52 - 001- 0
(Phone) ~2. !1'JD 0 (ot"JM
~f., ~'o~ la~~: ~ 55~72-JQ21
(Phone)
(Phone)
o New Construction
.
~e'ROOfing
o Alteration
ORe-Siding
OUtility 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 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
enter up07 tJefroperty to perfo lleeded inspections.
X ~~. ^f.25, (J3
Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
DDeck
OPorch
OLower Level Finish
o Fireplace
OAddition
PROJECT COST IV ALUE (excluding land) $
f/
Z/500. 0 0
$ r;4.75
$
$ 1.Z5
$
$
$
$
$
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
This Application Becomes Your Building Permit When Approved
Paid$O /~ ..t7U
Date q..- aX' /O-d
Building Official
Date
# $
# $
$
$
# $
# $
$
$
$ '/0. 00
/ ~
Receipt No. Lf'~07;(;:;;>
By rr ./
U
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 (95i) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
COMMENTS:
/J /J
/urol) I
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
rJ?- <Yr..?
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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,
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, 0 I URY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK; c..;~::J' REINSPECTION BEFORE COVERING
Inspector: ?r~ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI