HomeMy WebLinkAboutBldg Permit 03-1385
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
~. ";i:~e ~::y PERMIT NO. 'Cd I oL'"
3. Yellow Applicant V} - 3 aJ
(Please type or print and si~ at bottom) . '. _ _ _ _ _ ,,"-
ADDRESS '-II~// 66/ &51 &{) 0T,/"1JJ r/-61 fIb) '/1,'I6f/f{/) ~.?,g-~
LI/~( ~,T (f///A!~ J3 ~
LEGAL DESCRIPTION (office u~ /
LOT BLOCK ADDITION
~Wdk
OWNER
(Name)
kl vV tV Haf2A-<.~'/
(Address) Lj/~I
f' -
C J {'IA,I:-L ~_
ZO/;;:DseJ
PID ;(5"'" ~ 7;2- 001- ~
(Phone) Lf47 -&;/
BUILDER 'J~. .. ' J
(Name) I~f/(,,< ~<f/'t'QJ1?l'/ ~
(Contact Name) &2..@ .~-+A-<J;K <
(Address) /y.r:;,) (('J.f!] .:]t;, iY! #1'1:0 .Pilh""/
,
TYPE OF WORK
o Misc.
o New Construction
oDeck
(Phone)
(Phone) 9.9 "J/t) _S67y
/KJV 5S.)'SP
o Porch
ORe-Roofing
~ng
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 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 0 ial can re oke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the property to ryrform;reedej inspe ..
X fl/e A-J b.~ ~()31 'S rD 7 /ttJ// ~ /,1;3
, , Signature Contractor's License No. ' IYate
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
oLower Level Finish
o Fireplace
PROJECT COST/VALUE (excluding land) $
oAddition
o Alteration
$
$
$
$
$
$
$
$
-
7J5OU' _
(}::l it ~-
;1.. 75
I
This Application Becomes Your Building Permit When Approved
Building Official
Date
I Park Support Fee
I SAC
I WaterMeter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
Paid
Date
...--'
C7ld-K. -
(IJ- .16-- \.'"=)
# $
# $
$
$
# $
# $
$
$
$ ;;?-;H", - 1
Receipt No. q 2>?>0"~
By a.-
U "'
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
9/C:,/
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
...etrtNAL
o SITE INSPECTION
COMMENTS:
;/ /
pS ~ ;...; ~
~--
/.-. -
}
( /"~\~
'---
SCHEDULED
DATE TIME
yj~-k~
f
C J G'Y
CONTR.
PERMIT NO.
GJ3 -/3 oS-
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
.....-J ;' /"
( 0/-1 pJ/t:/r~
/
///
r/k:
--
------
)
~
/WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO.R~;:~OR REINSPECTION BEFORE COVERING
Inspector: /" /~ Owner/Cantr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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