HomeMy WebLinkAboutBldg Permit 03-0562
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File I PERMIT NO
2. Pink City . () ~ - 5" i-
3. Yenow Applicant .,:)
(Please type or print and sign at bottom)
ADDRESS ZONING (office use)
1105""'69- Ihs-'79
F'/ II~ k4///K'5"
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name) /1-~q)/::J #/rtPV
(Phone)
(Address)
BUILDER
(Name) ~/ AAJ'JA1A!.t1L6
(Contact Name) T A 5MJ 5 r&1df~/t!/ A
(Address) Lf3 ~ S&vrH sV-tfOd.J L/!-Kz
PID
/J9L/~TJQU~A./ ~ (Phone) 9s-~--;:J9J -S'.gR~
(!C9PSz:) (Phone) 7 S '2 - :J?;;2 '- S-.8$1{
BlfllJ I ::ro~t1AtOr /'Z1A/
TYPE OF WORK
o New Construction
ODeck
.e-Roofing
o Porch
OAddition
o Alteration
PROJECT COST IV ALUE (excluding land) $ / 4t;. ~~dJ
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 upon the pro to perform needed inspections.
- --.....------
-~
~ ~ Signature
OLower Level Finish
o Fireplace
o Misc.
;;)tt)o9?9 '/ ....?
Contractor's License No.
I Permit Valuation
I Permit Fee $
I Plan Check Fee $
I State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
I Gas Fireplace Permit Fee $
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
I TOTAL DUE
I Paid I..,~ .oct
I Date SItU () ~
This Application Becomes Your Building Permit When Approved
~' ~I-
5 !'lz,/a;;>
Building Official
Date
.s-S-3S- ~
ORe-Siding
S-~O?/OJ
Date
# $
# $
$
$
# $
# $
$
$
$ ff 7(,." tJ
Receipt No. ~tt~~2-
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, a Certificate of Occupancy must be
issued.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ~~~~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
..)i!t"ANAL
o SITE INSPECTION
COMMENTS:
-
~ (/
~'OOI
DATE TIME
SCHEDULED ~~~~
4e/~~k
CONTR.
PERMIT NO.
CJ? -S~.2
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
Cy/;~
/_~~
x:;"6S-<- ~
~WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~';. :.~:;S>R REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
,-
INSNOTl