HomeMy WebLinkAboutBldg Permit 03-0741
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ADDRESS
.3 79 (p
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(p. t:J.o3
I. White File
2. Pink City
3 _ Yellow Applicant
PERMIT NO. 03 --0 74/
/"7/7 .e-r/1
S /7U;-o /
ZONING (office use)
A:: / ...f.L:)
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER r .
(Name) A I t#~rz- Aile/( el~llLl
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
o New Construction
OLower Level Finish
PID 25 -/+3 - 662, - 0
. (Phone)
<i)) -yw...f<fd'9
(Phone)
(Phone)
ODeck
~e'Siding
OUtility Connection
OPorch
ORe.Roofing
o Fireplace
OAddition
OAlteration
PROJECT COST IV ALUE (excluding land) $
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~n prope"to p,e~. o:z!n le?~P~cti?s.. / ~ tLt/ '3
X 1/ &1L(~..:,( /?~/~C<'--, U f
V . S' ture Contractor's License No. Date
U
I Permit Valuation
I Permit Fee
I Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
2-,50 O. 00
$ '7-1- 7r
$ '-
1$ I~~-v-
I $
1$
1$
$
$
This Application Becomes Your Building Permit When Approved
Building Official
Date
I Park Support Fee # $
I SAC # $
I Water Meter Size 5/8"; I"; $
I Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE /') $ '7(P.OO
1/
I Paid "7"& .CJ7) Re~~~. ~.Zd
I Date (,. q (I] 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
~FINAL $ ,eL"-\. /'
o SITE INSPECTION'
COMMENTS:
SCHEDULED
M V"'~
Sf'".
DATE TIME
(p -2.15"-0 {.
s- 7'1 {
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
/
rORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORREc/rORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CAL~50 F~R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE ~Ul MENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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