HomeMy WebLinkAboutBldg Permit 03-0899
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
'1. '. 0]
(Please type or print and sign at bottom)
ADDRESS
~. ~i~i~e ~:;y I PERMIT NO. /\?_ Oaoa
3. Yellow Applicant U"":> ' l/ -/ I
4&35
15&-lIr;:- ms -rJv:1J~
LEGAL DESCRIPTION (office use only)
ZONING (office use)
LOT
BLOCK
ADDITION
PID 25. /Ir?. OCJt:f-~ 0
OWNER
(Name)
(Phone)
(Address)
.....!c 4. ~
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~/'l .I C'-:..- /
BUILDER
(Name)
(Contact Name)
(Address)
(Phone) 6/). 3C9r o~~ 7
(Phone)
TYPE OF WORK
~e-ROOfing
DAlteration
DDeck
o Porch
o New ConsttUction
DLower Level Finish
o Fireplace
DAddition
o Misc.
PROJECT COST/VALUE (excluding land) $
ORe-Siding
DUtility Connection
I hereby certifY that I have furnished information on this application which is to the best of my knowledge ttUe and correct. I also certifY that I am the owner or
authorized agent for the above-mentioned property and that all consttUction 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 pr~perty to perform needed in~.p.eecucti~o~ . '7 d _ D?
X ~...- ~.../ () /
Signature Conttactor's License No. Date
$
$
$
$
$
$
$
$
r $'1&.00
I )
I ReceiDYNo. ~ QJ
By /1/.
t!
Permit Valuation
Permit Fee
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1 ";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
Builder's Deposit
Other
#
#
$
$
$
$
$
$
$
$
#
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
#
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
I
TOTAL DUE
Paid rJ (p . (/V
Date 1 J' ,,0 )
This Application Becomes Your Building Permit When Approved
Building Official
Date
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
DATE TIME
M~>'
1,fj'? i51u# ftf{
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
C2.5 - m
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
,P-FfNAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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~ORK SATISFACTORY, PROCEED
/ 'd 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 cl SAFETY!
INSNOTl