HomeMy WebLinkAboutBldg Permit 03-1413
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/0.22.03
(Please type or print and sign at bottom)
ADDRESS
I. White File I PERMIT NO
2. Pink City . 013-/4-/"2
3. Yellow Applicant ~
/72..5+
S t/;1/J t;:, /
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Name) Il1
(Contact Name)
(Address)
i k! G () Iv --:"7"
,) evv~/
,
/~ 78.0 c; / e IV/)di (,
Af/& Al,.
,
ZONING (office use)
/2 IJ.o
PIDZG'. /..l~O()I. 0
(Phone) t)/-v7 - yO:d ::;l.
(Phone)
TYPE OF WORK
o Deck
ORe-Roofing
o New Construction
o Porch
DLower Level Finish
o Fireplace
DAlteration
DAddition
o Misc.
PROJECT COST/VALUE (excluding land) $
~e-Siding
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 official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the property to perform needed inspections.
x
Signature
Contractor's License No.
Permit Valuation
Permit Fee $
I Plan Check Fee $
I State Surcharge $
I Penalty $
I Plumbing Permit Fee $
I Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
~
Paid 'lU.VV
Date /tJ. Z'L. 0 7
Building Official
Date
Date
# $
# $
$
$
# $
# $
$
$
$ 7~.(}{)
I Re;;11<<- "3? / ()
IB/
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
SCHEDULED
DATE TIME
-0/~-
. ,
ADDRESS
/7.2Sc/ Sv~sef
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.Ji-FIHAL
o SITE INSPECTION
COMMENTS:
/I II
I~J'/de
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
C!)3 - / y'/.3
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
./'7 / /
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o CORRECT ACTION AND PROCEED
o CORRECT WORK, C~~L;~EINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl