HomeMy WebLinkAboutBldg Permit 03-1353
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/0.7 03
I. White File
2. Pink City
3. Yellow Applicant
(Please type or print and si~ at bottom)
ADDRESS /7~B3 SUtJJ'E:!
I~/L" S'tV
LEGAL DESCRIPTION (office use only)
LOT 22- BLOCK I
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ADDITION VV ()O 0 tit 6VV
OWNER,,- ,
(Name) I K\ <2"-:>\-t
S~H-f'.l)
(Phone)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
ODeck
~/
Re-Roofing
OAlteration
o New Construction
o Porch
OAddition
OLower Level Finish
o Fireplace
o Misc.
PROJECT COST IV ALUE (excluding land) $
Date Rec' d
PERMIT NO. () r .;" 1]53
ZONING (office use)
le-I S ()
PID 2..5. /85: 02..'L. ~
_'1.4411 c- y. ~ tv
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ORe-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
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- ~ Signature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
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
Water Tower Fee
Builder's Deposit
I Other
I TOTAL DUE
Paid 7ft). c./U
Date /0. '7-07
This Application Becomes Your Building Permit When Approved
Building Official
Date
$
$
$
$
$
$
$
$
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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
SCHEDULED --r~ ~ --
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/?~f'..1
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
A--PiRAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
-
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/Le /' CJCJ -r
L'.] - / .-.?S.3
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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CO~pt//-e- T~
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-------
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( (//as-e- /~ /e-
~WO~ACTORY,PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, C~:L ~EINSPECTION BEFORE COVERING
Inspector: ~ vwner/Contr:
~--...
~
~
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
1NSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!