HomeMy WebLinkAboutBldg Permit 02-1104
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yellow Applicant
(Please tyoe or orint and sign at bottom)
ADDRESS
J ~ 9 c; I /J1 u5hl-tJw# ~ D
(J/lJ()!t LK~e / /)1#
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
( )t) ~ N
(Address)
_-S A- M -L
BUILDER
(Name)
(Contact Name)
(Address)
~.e,LF
TYPE OF WORK
o Misc.
tYl '--~ ,J 1.e.-1
,
(Phone)
Date Rec' d
9- 5\r () 2-
PERMIT NOo02-_/ 104-
SS372.-
PID
ZONING (office use)
4'10- /600
ORe-Siding
DUtility 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
SUbmitt~~ I am aware that the building 0~~7 revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
~teruPVXpe~ee7J;::fL 9- (0 - 0 1-
/ Signatufc: (/ - A Contractor's License No. Date
~ U
z, 57nJ-. (JV
"7t/. 7 ~
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
(Phone)
(Phone)
o New Construction
oJ'
!B1fe- Roofing
o Deck
OPorch
DAddition
OAlteration
DLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
$
$
$
$
$
$
$
$
I Park Support Fee
I SAC
Water Meter Size 5/8"; I";
--
I. [..J
Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE
~J6.vv
q- ~ ..l/ 7 ____
/ -
This Application Becomes Your Building Permit When Approved
JttM-
q; ~ - 07--
I Paid
I Date
Building Official
Date
#
#
#
#
$
$
$
$
$
$
$
$
-
$'l(,.OO
/1 I _
Receipt~o. ~30 I U
r7
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 nME
CITY OF PRIOR LAKE ~ L. j /.
INSPECTION NOTICE SCHEDULED ~ ~ C,s-
ADDRESS /L?9/ ~,('~t:-/~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
~ I'!.SULA TION
pFINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
1~. ECH FINAL /J
/Ze /' ~OP-
COMMENTS:
AI)
~-//or/
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~~~L;..rEINSPECTION BEFORE COVERING
Inspector: r r~ Owner/Contr.
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INVtOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!