HomeMy WebLinkAboutBldg Permit 01-1283
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
. AND UTILITY CONNECTION PERMIT
1. White File
2. Pink City
3. Ye\low Applicant
PERMIT NO. 0/- 1 ~ <i? j
(Please type or print and sij!;l1 at bottom)
ADDRESS
/:+(J~ ~ KcL
. .
/5' Jj8~-
LEGAL DESCRIPTION (office use only)
ADDmON cfI~ Lak. C~
Date Rec' d
ZONING (office use)
Q..tgO
LOT
BLOCK
PID;::& -~oL/- ()O/-I
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Name) f'J"'w \\~,\ l- h......
(Contact Name) .\\"'\\'l~N'\ p\"'\~~ (<...,,> r,i
(Address) '"""\ <- '? 0 I', ( ". \.-
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(Phone)
(Phone)
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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
~ter~~the:~ertyto~~~. l) ( -'~T\ ') /) ,'-I \) \ l ,. 0'1-' n \
Signature -- Contra.cTor's License No.' Date
r
I Permit Vatuation I ::J.5 00 ' -
I Permit Fee . $ 7(/- "1~
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 $
~ {1 \ <:...
t'\..L c.~
TYPE OF WORK
o New Construction
ODeck
OPorch
~e-ROOfing
OAlteration
OLower Level Finish
o Fireplace
OAddition
o Misc.
PROJECT COST/VALUE (excluding land) $
I" J-S-
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
Sewer/Water Connection Fee
#
#
#
Water Tower Fee
#
This Application Becomes Your Building Permit When Approved
I Builder's Deposit
lather
I TOTAL DUE
t! Dc)
I Paid 7 fa (
I Date JI-q-I
ORe-Siding
OUtility Connection
$
$
$
$
$
$
$
$
$ '70'~
.-
. Receipt No. UOq {/' /
By ~J/
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, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
11- J:S-O (
I~~O
ADDRESS /548S Hcn})a.cxL l-01..e l(~.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
OI-12~ '3
COMM
"
o PLUMBING RI
o M CH RI
o TER HOOKUP
R HOOKUP
BING FINAL
MECH F L
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o FOOTING
o FOUNDATION
o FRAMING
A ~INSULATION
f'f ~ FINAL
o SITE INSPECTI
-
~ORK SATISFACTORY, PROCEED
o CORRECT ACTIO~ND PROCEED
o CORRE~RK, LL FOR REINSPECTION BEFORE COVERING
Inspector: ~ --;; \. Cl.J# Owner/Contr:
CALL ~7-98~O ;OR TH{ NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI