HomeMy WebLinkAboutBldg Permit 02-1187
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
f-u-()Z-
I. White File
2. Pink City
3. Yellow Applicant
PERMIT NO. ~?r/ 1'7
(Please type or print and siltll at bv~."u.)
ADDRESS
i 5" t7 (j FrLth If I;h Ir- 1,.
s. (::-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
1-16 IAfq H-) 0/, t't 1/1
.c.
(Phone) :}5'"). -tfl(7-(j (p f J
(Address)
BUILDER" / J.:) f\
(Name) ~..e / l1 fl ad '+-i '''1 a
(Contact Name) . J
(Address) <; /O.(j G"kC 'P ! s /'0 y- e /11 r(
ZONING (office use)
l??
PID Z~ - ~(, - ~ IZ --t)
(Phone) ~! ~ -V ~ - <?' ~
(Phone)
TYPE OF WORK
o New Construction
o Deck
o Porch
OAddition
.....e- Roofing
OAlteration
OLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $ ~P\O
o Misc.
r;o
ORe-Siding
OUtiIity 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 up~e~to perform need;:.inspections.
X J ~/ L.-"1 ~ Ir) ,e:;-o <=J-)...g-cr:2.
. Signature ~ "'-J Contractor's License No. Date
I Permit Valuation 2 ~ DJ?} ~ (j7.J Park Support Fee
I Permit Fee $ 7'-f.1J SAC
I Plan Check Fee $ ... Water Meter Size 5/8"; I";
-
I State Surcharge $ I,. {.,-r I Pressure Reducer
I Penalty $ I Sewer/Water Connection Fee
I Plumbing Permit Fee $ I Water Tower Fee
I Mechanical Permit Fee $ Builder's Deposit
I Sewer & Water Permit Fee $ Other
I Gas Fireplace Permit Fee $ I TOTAL DUE
.~ ~' -' -- ,
Paid '/VL/V ~
9 '1A/- v-z.,.- Date d . %tI- (/ z..-
;
Building Official Date
$
$
$
$
$
$
$
$
$ 7~, (/lJ
fl' Recei o. #SIJ {,:?
By
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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
OA TE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/5870 ~JJ/Gt-lrV 77U-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
2.::J /67
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
/co Or::
~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~, C~OR REINSPECTION BEFORE COVERING
Inspector: f/~ . Owner/Contr:
/I ·
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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