HomeMy WebLinkAboutBldg Permit 03-0934
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
7. /5 03
I. White File
2. Pink City
3. Yellow Applicant
(Please type or print and sign. at bottom)
ADDRESS 7//
/(15'71 MrhvJtJoj /fd
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
/-)~"rn~cll ;)tJnn?,-- ))iAt'OJ1/-
/6;;)71 ;Vtrft, WP()c! J?c).'
(Phone)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
.~oOfing
DAlteration
ODeck
o New Construction
OPorch
DLower Level Finish
o Fireplace
DAddition
o Misc.
PROJECT COST IV ALUE (excluding land) S
Date Rec' d
I PERMIT NO. 03 -0954-
ZONING (office use)
PID 215 ./efl. Od4-, 0
LJ'I7- ;;'996-
ORe-Siding
DUtility 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 fi the ab ve-mentioned property and that aU construction will conform to aU existing state and local laws and will proceed in accordance with
submitted plans. am aware 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 ro erty needed inspections.
X .~-..)-----.
Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee $
I Plan Check Fee $
I State Surcharge $
I Penalty $
I Plumbing Permit Fee $
I Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace 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
I Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid '7~# {/tJ .
Date I. IS ,OJ
Building Official
Date
# $
# $
$
$
# $
# $
$
$
$
/1
(f
,
7(p. tV
?57J~ 4-
This is to cenify 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
DATE
~k
, I
/6S7/" ~r#~{)(J'
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA liON
..,.c.. ....iNAL
o SITE INSPECTION
COMMENTS:
//00 ;
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
/""' J /
Ca~//~ f-~
,
TIME
Q]-?J.?
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/~-~-~\)
~~S-e- N~ ~
~ORKSAT ,r"l'\v\.#t;ED
[J CORRECT ACTION AND PROCEED
o CORRECT WO,RK, ~A:L-'" REINSPECTION BEFORE COVERING
Inspector: Ptt'~ Owner/Contr:
,
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
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