HomeMy WebLinkAboutBldg Permit 02-1113
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yenow Applicant
Date Rec' d
9- 9- 02-
PERMITNO. (J'l-II!3
(Please type or print and si2Il at b~~~,,~&)
ADDRESS
Z, 95 Z- 5/;1/2-1 V ti Lie:... ,
LLJ
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
PID 2$.- -1.7]' ~~S7J,- 4
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 upon the pr erty to perform needed inspections.
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OWNER
(Name)
(Address)
BUILDER
(Name)
G-i f'rJ \J
(Contact Name)
(Address)
TYPE OF WORK
. o Misc.
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
(Phone)
2..( skovs~Y
(Phone)
(Phone)
o New Construction
~~e-ROOfing
OAlteration
oDeck
o Porch
OLower Level Finish
o Fireplace
OAddition
PROJECTCOST/VALUE (exdudingland) $
Contractor's License No.
Park Support Fee
#
$
$
$
$
$
$
$
$
SAC
#
Water Meter
Size 5/8"; I";
-
{ . "t.- r-
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
#
#
This Ap .lication Becomes Your Building Permit When Approved
2!;IlJJ- q , 9 .,; 1-
Building Official Date
Paid
Date
'/r.,.o 0
1/- 9" - 1J2.
Receipt~o. e?-.3(JZ-U
b1,
ZONING (office use)
t:t~ ~-'l-CfO A 6 3as
ORe-Siding
OUtility Connection
q I C"f , (J d...
ate
$
$
$
$
$
$
$
$
$/~.(/{)
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
CI1;.Y .oF PRIOR LAKE
~ INSPECTION NOTICE
SCHEDULED
ADDRESS
14f)
~rp~,.",~ LlL fZJ.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULA TI9t' ..&. 0 SEWER HOOKUP
18 FINAL t\o'Ol 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: (f?)
,
d Q51-
DATE
It
t{ -l. 3
A-JJJ "3
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
,
r '_
j' f' '-
jlfWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
II) N1 ,.. q,.t.. y oJ-
Inspector: f V,. Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!