HomeMy WebLinkAboutBldg Permit 03-1045
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I PERMIT NO'(jB.-" !()tt3(
I
I. White File
2. Pink City
3. Yellow Applicant
(Pl'=_~. rint. _~"b~~
[ ADDRESS
99 {!.. ri to('){J 0
(~ -
.0.(:,"
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
OWNER
(N ame)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
ODeck
OPorch
o New Construction
OLower Level Finish
o Fireplace
OAddition
PROJECT COST IV ALUE (excluding land) $
L..J Misc.
ZONING (office use)
PUfJ
PID;;S'-~39-o/!1
(Phone) (C;~J-,.;r?5'- S '06&
(Phone) ~ -~ 0'?-- ~
(Phone) Z) .?:i - .)C\ .
ORe-Roofing
e-Siding
o Alteration
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 ab e-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I a e that the building official s,an revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the ope to perform ~e~ ~
X - ~ ~u~B~ .
Signature Contractor's License No.
Water Meter Size 5/8"; I";
Pressure Reducer
Park Support Fee
SAC
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
# $
# $
$
$
# $
# $
$
$
$ 7~ . --
1~;&:-~qgBI
This Application Becomes Your Building Permit When Approved
Paid
Date
ff/
-Co---5
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
DATE TIME
CITY OF PRIOR LAKE JIII'~J ;: _
INSPECTION NOTICE SCHEDULED ~---
ADDRESS 5577' 6.ctr~1
OWNER
CONTR.
PHONE NO.
PERMIT NO.
t23 -/oYS-
D FOOTING
D FOUNDATION
o FRAMING
D INSULATION
....tif-tr1NAL
D SITE INSPECTION
o PLUMBING RI
D MECH RI
o WATER HOOKUP
D SEWER HOOKUP
D PLUMBING FINAL
o MECH FINAL
D EXIGRAD/FILLlNG
D COMPLAINT
D FIREPLACE RI
D FIREPLACE FINAL
D GASLINE AIR TST
D
COMMENTS:
~s/~
...-, ~.1
6~p /e /e-
/
~/ ~
( . /OJ-€ ~< ~
~WORK SATISFACTORY, PROCEED
D CORRECT ACTION AND PROCEED
:,=CT~ FOR RElNS::::FORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INS/iOTl