HomeMy WebLinkAboutBldg Permit 02-1285
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
14~(PZ- 6LeJVO~
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
"S"'ff..Ve.
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
VcSPE<:::Te.b
o New Construction
OLower Level Finish
I. White File
2. Pink City
3. Yellow Applicant
Date Rec' d
/0./.01-
PERMIT NO. 02- -1Z-6E:'
Af"G sC
PID
ZONING (office use)
~Jt)
(Phone)
~5'2. ~ '7$5'7-
(Phone)
(Phone)
DDeck
o Fireplace
OPorch
ORe-Roofing
~e-Siding
OUtility Connection
o Misc. , PROJECTCOST/VALUE (excluding land) $
I
I hereby certify that. I have furn~' sh information on this apPl.ic. ation which is to the best of my knowledge true and correct. I also certity that I am the owner or
aUtho.rized'tnt r the ab :ve-m tioned p.roperty and tha~all .cons~ctionwill conform to all existing state and local laws and wil.l proce~d in accor~ce with
submitted p s am ar th the buildin _~ ; ."..' thiS permit for Just cause. Furthermore, I hereby agree that the City offiCial or a deSignee may
enter upon 1 \.. ,,__' __ p neede . s . s.
X ID-J-O~
{/Signatu e Contractor's License No. Date
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
'Z,50 o. DO
$ 7{ 7s
$
$ f. Z,..S
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
W)L 10.7-07-
Building Official Date
DAddition
DAlteration
$
$
$
$
$
$
$
$
$ '"'if/?- (/lJ
.
.".30'1&
I Paid
I Date
7(0. r/U
/(j.,-()7--
Rece~tb7o.
B~.
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.
I Park Support Fee
I SAC
Water Meter Size 5/8"; 1";
Pressure Reducer
#
#
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
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
#
#
Planning Director
,.
DATE TIME
CITY OF PRIOR LAKE J-{ ( II .u (j
I~SPECTION NOTICE SCHEDULED
ADDRESS / q fv&2 &!~~dcJe L
OWNER CONTR. .~~@
PHONE NO. PERMIT NO. :1 - (). y..::.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI 0 EXlGRADIFILLlNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
r- 0 MECH FINAL,/ .. ~'9D
h///14(( oi A / Li-5~'d, '" ~
'" --
t7\aO Oyl -J1dytJ, ~/k
c/ ·
COMMENTS:
(j) F-I vq 5 I,
.....;
/"
/
~
I
I 115>
.,.---,. J
I- / l-c .,)
.
~ v
~ WORK SATISFACTORY, PROCEED
, CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: (l;'f .J- (("'d;? Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
IJ'ISNOTl
"