HomeMy WebLinkAboutBldg Permit 02-0644
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERI uICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(please type or print and si~ at bottom)
ADDRESS
IfJ7;) P L&11r ANi
LEGAL DESCR1r uON (office use only)
LOT
BLOCK
ADDITION
':.
I. White File
2. Pink City
3. Yellow Applicant
PERMIT NO. ()z"O h44-
5t: S/~I
OWNER
(Name)
LARRY
,
If/7J..
0, Gtl1R jtJ
fie AflrtJ/ .>t: .;'13,
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
ODeck
o New Construction
OLower Level Finish
o Fireplace
PROJECT COST /V ALUE (excluding land) S
o Misc.
(Phone)
(Phone)
(Phone)
OPorch
OAddition
~e-Roofing
OAlteration
PID
ZONING (office use)
95~- ~~6-~//b
ORe-Siding
OUtility 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
=ter~ prSJ~f ~needed inspections.
, Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee $
I Plan Check Fee $
I State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
I Gas Fireplarl Perm~t Fee $
/~ "'-I {I
{JfJr-'Y="'-;="~~7:
Buil~ Official Date
I
2,5"CJC;J .00
7t.( . 7s-
l'~
I Park Support Fee
I SAC
I WaterMeter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid
I Date l.. -'SO--crZ.....
#
#
#
#
$
$
$
$
$
$
$
$
$
I Receipt No. l.f ~ I ~O
I By if)
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) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
DATE
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
4172
_ PLEASANT
02-0644
Re-Roof
OWNER
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 EX/GRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
CLOSE FILE
t\\i"~ tll:::llI:::l ;)UII, Su;IJirl~ :LrI~p~t.lUJ'
nJ:'f 9. 7001
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl