HomeMy WebLinkAboutBldg Permit 02-1199
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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ADDRESS
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I. White File
2. Pink City
3. Yellow Applicant
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LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
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OWNER A
(Name) ~>dCf~//MJ -
(Address)
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(Phone)
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TYPE OF WORK
o Misc.
17 ~"~)
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o New Construction
ODeck
o Porch
ORe-Roofing
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I PERMIT NO. tJJ.- II~
ZONING (office use)
J<;)~SD
PIDd5--JdO~O()/-O
9 _s ;). '1 Lf 7. ~ )69
0/;. ;);)/- i);)53
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~e'Siding
OUtility 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 oke this permit for just cause. Furthermore, I hereby agree that the city official or jdeSignee may
;",upontb'p, to ~= ;ft~~c:..?-.:,.
Contractor's License No. _'.
OLower Level Finish
o Fireplace
OAddition
OAlteration
PROJECT COST IV ALUE (excluding land) $
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
$
$
$
$
$
$
$
$
I
I
I
/ ,J-S-I
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
Pressure Reducer
;AC:;60,--
-;q, 7~
City SAC and WAC
Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
This Application Becomes Your Building Permit When Approved
I Paid
I Date (j-_2~~
Building Official
Date
# $
# $
$
$
# $
# $
$
$
$ '7(P ,Of)
Receipt NO/~l/5
By fr~
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
_i{ LAKE
, liON NOTICE
SCHEDULED
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ADDRESS
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OWNER
CONTR.
PHONE NO.
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~ FOOTING
o FOUNDATION A).
o FRAMING r ,
o INSULATION
o FINAL
o SITE INSPECTION
PERMIT NO.
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COMMENTS:
o PLUMBING RI 0 EXIGRAD/FILLlNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
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,(,r WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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Inspector: } ( I - U - ./ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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