HomeMy WebLinkAboutBldg Permit 03-1394
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
10,1C-OJ
I. White File I PERMIT NO
2. Pink City . ? _I] Ii ~~
3 Yellow Applicant J I ~
MO\'Ple Ir
(Please type or print and si2Il at bu"um)
ADDRESS
~Ii (Y\ G.(ih,\~pr
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
OWNER..-r .
(Name) '"' I (Y\
(Address)
IL{LR~3
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
,Ljlp~3
ADDITION
PID
ZONING (office use)
(Phone)
L/ Lj 7 - ~3-7)cr
$
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
Pressure Reducer
#
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f'-t\ \ Ke
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b (C1 V'\3 er
,\AV\iP \e Tr
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St-
-LV! c.
(Phone) --9 t) JJ-t{ C[2J- :? 8Y ~
(Phone)
:J{j'rdun
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
;teruponth;;?/~~o~ dOl a ~ 11) /0//5/0.2,
. - 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
Mechanical Permit Fee
Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
$ Jlovt/V
. ReC7iP . o. -f-'a for
By
'-
"CQth
o New Construction
o Deck
~e-ROOfing
OAlteration
OPorch
o Lower Level Finish
o Fireplace
OAddition
PROJECT COST IV ALUE (excluding land) $
Lf 7{)(.J. 0 ()
#
#
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
#
I TOTAL DUE
I Paid 'I /, .1:/1..1
I Date I Id.lC o?
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, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ~~~~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
-&-ftNAL
o SITE INSPECTION
COMMENTS:
.t&yeo r
SCHEDULED
~/.?~
/
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~&~
.., "
///
TIME
cB-/J9Y
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/J /
LC1~ /:J ~ rfL
,
...-""l /"' "..,- I
C-:{CYS-e /-/ /cp
~K SATISFACTORY, PROCEED
o 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 &: SAFETY!
lNSNOTl