HomeMy WebLinkAboutBldg Permit 02-0598
(Please type or print and si2l1 at bottom)
ADDRESS
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Date Rec'd
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
'I AND UTILITY CONNECTION PERMIT
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LOT /O!BLOCK
LEGAL DESCRL.t'TlON (office use only)
ADDITION ,IV~~YI1~ c;:J
O~ER ~
(Name) r1 ~x..
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
1~
,
o New Construction
OLower Level Finish
1. White File
2. Pink City
3. Yenow Applicant
S-2Lj-OZ-
PERMIT NO. Ol -OS-9/!J
/2AJ no
(Phone)
(Phone)
(Phone)
ODeck
OPorch
OAddition
){Re-ROOfing
OAlteration
PROJECT COST IV ALUE (excluding land) $
o Fireplace
ZONING (office use)
elf!?
PID~-/4-/- oc'7-a
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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 a1l construction will conform to a1l existing state and 10ca1laws 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
~t<< upon'" propmy tu P~:a::"?"'. ......
X 11J-7~f .~ '7 ~J..J-dJ
" 19nature Contractor's License No. Date
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
Z, '5ItI (). 0 t)
$ 7e.1.7r
$
$ /.;z...~
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
~ ~.t""d7-
Building Official
Date
I Park Support Fee
I SAC
Water Meter Size 5/8"; 1";
Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
'/ (, . (/C-/
,-z.~ -II-z-,
Paid
Date
#
#
#
#
.$
$
$
$
$
$
$
$
$ r?6,.'O
I ~
Receipt 1;/gf, ,. U z;,. ~
By #Jf,) ~
t/
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
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1+7.
ADDRESS
ICO~ 7 AJorrh woJJ flcL
~
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING f.G) 0 WATER HOOKUP
o INSULA TIQN . . 0 SEWER HOOKUP
. FINAL It.()() )..- 0 PLUMBING FINAL
o SITE INSPECTION ' j \ 0 MECH FINAL
COMMENTS:
no
OWNER
PHONE NO.
).-.)"1Y
+Car'
.
CONTR.
PERMIT NO.
;2- ~o/ It'
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
-
~
v, ~ ./J<C...:!.,. C/V'\
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......... .......'-:. ...... ~-, .' L
L.. :....j.. j.. . ,. .
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It WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: fl,r1 1 -'1, L( "d2"'Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSIiOTl