HomeMy WebLinkAboutBldg Permit 03-1055
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
g,I/.OJ
I. White File I PERMIT NO
2. Pink City . /1? _ /'tJSC:-
3. Yellow Applicant t.'-> J
(Please type or print and sign at bv"vm)
ADDRESS
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~/Da6
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT :J BLOCK
/ ADDITION
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PID 2~ . 08] . ClOY, ()
OWNER r
(Name) +- J-lJ Ai
.
#! J js 130'\
1~t78) nAt. f21JC1Q _ r!Z
I
(Phone)
c{"Y<11~ %0?
(Address)
~
(Co..' ,
J!IIIII" -~
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.......
(Phone)
TYPE OF WORK
o New Construction
ODeck
o Porch
ORe-Roofing
ftRe-Siding
OUtility Connection
OLower Level Finish
o Fireplace
OAddition
o Alteration
o Misc.
PROJECT COST IV ALUE (excluding land) $
I hereby~e' 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
authorize ag t for the above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
SUbmitte~1 s. I am aware that the. building official can revoke this permit for just.~""" F""",""ore, I h<reby 'gre< that th'.C. ity official or a. designee may
:nter up.:n e ~ffperty to P~ded inspections. ()DO;} It ~ ~ W-o
i:T ~ Cootn""r, Li"""No. ~
Permit Valuation I Park Support Fee # $
I SAC # $
I Water Meter Size 5/8"; 1"; $
I Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
~cr $
I TOTAL DUE $ '1 h. 0 ()
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
,
This Application Becomes Your Building Permit When Approved
I Paid
I Date
Receipt No.
By
Building Official
Date
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 (95i) 447.4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
;;~/~ /Q, t _ TIME
SCHEDULED -$rh /0"
al' /t{,e
CONTR.
ADDRESS
/ S'";26 X
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
COMMENTS:
_/7 /
J7Ls)d~
,
PERMIT NO.
CE - /~3-
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/"/ / /
(~~/Jle T~
/
~
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( ~_lo5'-e /7 ~
"- --------
--------.
~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~~/~A.J 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!
IJISNOT!