HomeMy WebLinkAboutBldg Permit 02-1100
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
tJ-5 -(Jz'
1. White File I PERMIT NO
2. Pink City . ().:z... - / / () 0
3. Yenow Applicant
Lf en 'd fi>
(Please type or print and siRll at bottom)
ADDRESS ZONING (office use)
l-orr1~ <;;t
ALE.
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
(Address)
S+~ '1,\
K:v'V\
BUILDERr
(Name)-S. ~1Q.,
(Contact Name)
(Address) LfJO (; CXC e It;~t).r e I vol.
TYPE OF WORK
o Misc.
RA&,'V\{j
PID zS . 'f$~ - 01.1',. 0
(Phone)(",}- r3(/~
(Phone) ~~~-&O c;. <(,
(Phone)
o Deck DPorch ~t:-i\.OOfing ORe-Siding
o Fireplace OAddition OAlteration OUtility Connection
PROJECT COST/VALUE (excluding land) $ II, /lit r\
o New Construction
OLower Level Finish
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
;terupon the P5~;~in~ections. / if SO CZ:s _ 0 ~
Signature I '\J'" Contractor's License No. . Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
?-, 57/li OV
$ 7L/.7S-
$
$ 1_ L.-r-
$
I $
I $
1$
1$
This Application Becomes Your Building Permit When Approved
~ 1,.J-()Z--
Building Official . Date
I Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
7(,. Vf.;'"
eIj. \ "{)?"-
,
I Paid
I Date
# $
# $
$
$
# $
# $
$
$
$ 1i-.c u
r
Recei{'~o. 4-SdO J
Bv~
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.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, tax (952) 4474245
16200 Eagle Creek Avenue Prior Lake. MN 55372
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
~ Z-fo t-{)/GOS Sr
OWNER
CONTR.
PHONE NO.
PERMIT NO.
Z -/IOC)
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 EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
/f!4fOr
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/ /' t O~..e.-- t'- I 'Y
I (/\' - ./
( -- ~
'- ~
-"~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CAL OR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI