HomeMy WebLinkAboutBldg Permit 02-0575
(Please type or print and sUm at bottom)
ADDRESS
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERIUICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yellow Applicant
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LEGAL DESCRL.t'uON (office use only)
LOT 1 BLOCK ~ ADDITION ~~
OWNER
(Name)
DON 5e-A ro roe--
- .
(Address)
BUILDER
(Name~./'lCP~ fY\_M-e,J~ JAJ <=-..
(ContactName)~ \iU .p4+-1~f;~o~
(Address) 'l4 q1) t'Vu..t.s L I"D ~ N K...o
TYPE OF WORK
o New Construction
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~
PERMIT NO. O~- S-'7~
ZONING (office use)
RlSD
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(Phone) #t/'i- 3 'fJO I
.
(Phone) q~- \..fL/"l' 0.3 oD
(phone) to, 2- J] S"" - -Rob
ODeck
OPorch
ORe-Roofing
ORe-Siding
OUtility Connection
OLower Level ~h . 0 Fireplace OAddition OAlteration
o Misc. t1Jl.ttJ~iZ,J .I~~A -- A_A ~JECTCOST/VALUE (exdudingland) $ ~OO 0 of!-
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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
enter upon the prvy....f to perform needed inspections.
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Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
Signature
$
$
$
$
$
$
$
$
3~.e:>o
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. l7/J!' . atio.>n]ec.omes Your Building Permit When Approved
WJI(~"//t. '5-2'2..
BUilJfug Official Date
Contractor's License No.
Park Support Fee
SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
Builder's Deposit
Other
I TOTAL DUE
I Paid.'J.3X.g b _
I Date '!>,.. ~;+. -U cJ.
#
#
#
#
Date
$
$
$
$
$
$
$
$
$ J3~,g'~
U::J/.)<;t( I
, - i
ReceiPt No.
. >By pnr-
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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
U hour notice (or all inspections (952) 447-9850, tax (952) 4474245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
c5-::>.l./.~ ~; 3D
ADDRESS
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(ho..JA.}CJY R~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDA nON 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULA nON 0 SEWER HOOKUP
I'~INAL 0 PLUMBING FINAL
- 0 S1rE INSPECTION 0 MECH FINAL
COMMENTS: ~~
~-S-'7~
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
( ,K7-'f"4~)
/NSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!