HomeMy WebLinkAboutBldg Permit 02-0668
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File I PERMIT NO ~
2. Pink City ./i)", _ I /
3. Yellow Applicant ~~ ~ (9
(Please type or print and siltll at bottom)
ADDRESS
\6717 Lree.\~;Je C~~
ZONING (office use)
1<-(
PO'~or '_lA'Ke,MN b53~
LEGAL DESCRIPTION (office use only)
IJJ~w j~
ADDITION \. \t1- fI- A/)J;d/ H ~
LOT I~LOCK
.
PID2S- JoLl- ()j8-D
'et+ y GQ~\ger
\ 6/11 (,{' eekS,de L\rL\e.
U ()~\-e..~ Con~truc..ti 0 ('\
OWNER
(Name)
(PhoneA<15~) - d.db- d.) Sd-..
Pf~O' LtAKe, MN ;S~7~
(Address)
BUILDER
(Name)
(Contact Name)
(Address) \ 7 d-.5
(Phone) (45J.).-?> I,f(. - q lf4.<i<
(Phone)
(. '\<4f\ hQssen . M t\l
,
ules\'
1) r; VE
S5~\ 7
LA\e
~e-Roofing
ORe-Siding
o Deck
OPorch
TYPE OF WORK
o New Construction
o Fireplace OAddition OAlteration OUtility Connection
PROJECTCOST/VALUE (exc1udingland) $ 5 ~ d.-5 t 1 ::l.
OLower Level Finish
o Misc.
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
;ter1:iepro ertY. P~.fu'\"lfdedinspectiOns. ~O \ 6Q 7 \ \ 6 - Lt- O~
Contractor's License No.
Date
# $
# $
$
$
# $
# $
$
$
$ 1~~cD
Receipt No. ViA/ Lf3
By (j--O_
./
;;;S- ()!)~
$ 7tf,75
$
$ l r)5
$
$
$
$
$
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
Park Support Fee
SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
lather
I TOTALDUE
. )' ~1)
I Paid f1h. V.v-
I Date 1,.,-5-0 cr----
This Application Becomes Your Building Permit When Approved
Building Official
Date
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.
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
Planning Director
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
OWNER
16717
CREEKSIDE
02-0668
Re-Roof
ADDRESS
PHONE NO.
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 EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
CLOSE-fItE
/9\ik~ ft:; I t::;1'::>UII, ouilJing :i:n:spector
oce ~ 2003
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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