HomeMy WebLinkAboutBldg Permit 03-0778
(Please type or print and sign at bottom)
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
31q~
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LEGAL DESCRIPTION (office use only)
LOT 3cA3LOCK ADDITION.17 O1ti.vLu7!Jd
OWNER
(Name) ~. (V\a. ~~\~~
(Address)
Date Rec' d
PERMIT NO. 03- ??J/
ZONING (office use)
,el SO
PID.~'}~ -/ L/ J- {/ I d--6
(Phone) 15d -JjLf7 - Is/e;
. ~~;~~R~eC)'"\LCl'lO 'L ~'v\^t:. (CU1.fZ \~~
(Contact Name) 6,,<Lu~
(Address) ,s1oo ;1OS1.kSf.. t:
TYPE OF WORK
DMisc.
o New Construction
OLower Level Finish
(Phone) ?5) ~ ;).d~'- d? 00
(Phone) ~I J.. r 8i..! 0 -5;> 8'"3
ODeck
o Fireplace
OPorch
ORe-Roofing
o Alteration
PROJECT COST/VALUE (excluding land) $
DAddition
~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
~teruponthe:~~~ Lit b ({ 6(/ ~/(j '3>
Signature " Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
Penalty
Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
;;ZC)o() ,-- I
$ it;r75.1
$ / . d6
$
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
Building Official
Date
I Park Support Fee
I SAC
I WaterMeter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid .~,,-_"
I Date {p - I? -....::.:5
# $
# $
$
$
# $
# $
$
$ ( \
$17~ .t1v
Receipt NoLlLl'ff~r!'
By bJf\.-/
{I
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, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
. J1h-s -
ADDRESS
, <' /y~ 4#er/7V~ c;-
OWNER
PHONE NO,
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
COMMENTS:
/ r /
/-eslcl e
CONTR,
PERMIT NO.
C2" 77?
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/7 / /
(.aP4p/e 7~
,
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..tf WORK SATISFACTORY, PROCEED
f ~ CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ ~ Owner/Contr:
-
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI