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HomeMy WebLinkAboutBldg Permit 02-0514 (Please type or print and siWl at bv.~~) ADDRESS CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT Date Rec' d S-/]-PL 1. White File I PERMIT NO I 2. Pink City . 02--05/4- 3. YeI\ow Applicant 1-E5V P&e:rtS'J7-1V / Sj LEGAL DESCRIPTION (office use only) LOT BLOCK ADDITION OWNER (Name) (Address) BUILDER (Name) (Contact Name) (Address) AAA'"'$ ~ ..yT~!N /,:;..;2 7/ ~5 #00,0. ZONING (office use) ?7 PIDZ5-{)OZ-- tJ2--/-- tJ\ (Phone) /? 1'-1 J Ie/' ~,I( S' d1oA.s' a!~<d J2 I/#;A frtl-- L/~/ 7 $10(5- (Phone) 6"1;l.. 7 ~? 51' ~ '1 /? ~ /I . '/?~l(~A) /.-..Q'~I1Ic;.JI///~, .~/d ! j ./.7 (Phone) o Deck OPorch ~e-ROOfing OAlteration TYPE OF WORK o New Construction OLower Level Finish o Fireplace OAddition o Misc. PROJECT COST IV ALUE (excluding land) S 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 pi 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 epro rty pe~neU;?~ .57f? /b~ / Signature / Contractor's License No. ./ r D~ I I I Permit V aluation ~ I Permit Fee I 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 ~/5"OO.OO $ 7~ 71 $ $ $ $ $ $ $ I Park Support Fee I SAC I Water Meter Size 5/8"; I"; I Pressure Reducer Sewer/Water Connection Fee # # # 1.2-! Water Tower Fee # I Builder's Deposit I Other I TOTAL DUE I Paid I Date 7CR . 0 () t':;"" - 1./ - c) Z- This Application Becomes Your Building Permit When A.....u .:ed p~ 5-ls-07-- Building Official Date $ $ $ $ $ $ $ $ $ 1ft;. 00 ~~C'!fJjCzo~ I 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, fax (952) 447-4245 16200 Eagle Creek Avenue Prior Lake, MN 55372 CITY OF PRIOR LAKE INSPECTION NOTICE DATE TIME SCHEDULED 5 ~ 11- ~#t ., r. ~aACMvJ G+ ADDRESS Lf5S0 OWNER CONTR. PHONE NO. PERMIT NO. ;J-- S"/4 ~ o FOOTING o FOUNDATION o FRAMING ,,0 ~SULATION 0, _ P ~INAL TWO o SITE INSPECTION o PLUMBING RI o MECH RI o WATER HOOKUP o SEWER HOOKUP n PLUMBING FINAL o MECH FINAL o EXlGRADfFlLLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GAS LINE AIR TST o COMMENTS: 'I , CJbKu ~ , ~ORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WORK'%FOR REINSPECTlON BEFORE COVERING Inspector: C Owner/Contr: I ' CALL 1<<7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE., CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYl lNSNOT] -,,~