HomeMy WebLinkAboutBldg Permit 03-1250
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3 . Yellow Applicant
Date Rec' d
t'( 17 OJ
PERMIT NO. {)3~ /Z6U
(Please type or print and sign at bu"um)
ADDRESS
/~ 0 {)9
fl/O/C4?-1 WOOO
,e,a
LEGAL DESCRIPTION (office use only)
ZONING (office use)
le/fO
LOT
ADDITION
PID 25./ ~/. 084-.0
BLOCK
OWNER ~ /
(Name) ~""L
;;;:A AI PEA"
(Phone)
~9'/- ?'9'f-t'
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
~e-ROOfing
DAlteration
o New Construction
DDeck
o Porch
DLower Level Finish
o Fireplace
DAddition
o Misc.
PROJECT COST IV ALUE (excluding land) $
ORe-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 a e that . 'ng official can r voke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon th 0 0 nee inspections.
I)
R.eceiuYNo. ~(, JZ/
By /J,..,
o
x
Contractor's License No.
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 $
Park Support Fee
SAC
#
#
I WaterMeter Size 5/8"; I";
Pressure Reducer
City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
Paid "7~.O D
Date . Ij. '1.0/
#
#
This Application Becomes Your Building Permit When Approved
Building Official
Date
:7-/7-(7 :3
Date
$
$
$
$
$
$
$
$
$ '7~. 00
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 (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS /bPO ~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
A-FtRAL
o SITE INSPECTION
COMMENTS:
/eroof
DATE
( f'/d's-
/ ~
/f{r~~ao[
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
/? / /
U:;;#1. p::j (e 7e
/
TIME
a-/~f)
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
--- -
~:e N_' )
ar-wORK SATI . . ..n.v"t:t::~
/0 ......CORRECT ACTION AND PROCEED
o CORRECT WO~~:,A~R REINSPECTION BEFORE COVERING
Inspector: ./' ~ L- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl