HomeMy WebLinkAboutBldg Permit 02-0333
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
4-9-112-
I. White File PERMIT NO
2. Pink City ./1Z" 0 ???
3. Vellow Applicant V" ~ ...,
(Please type or print and sism at bv...u~)
ADDRESS ZONING (office use)
/SLf3/ ~l'7'1
LEGAL DESCRil'uON (office use only)
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PID
ADDITION
LOT
BLOCK
LoW~I/ FI:'
.. ,
1~43J B~~' rRa{
BUILDER ..D
(Name) ~~u ~4!J? .'1~.
(Contact Name) 117()k .I~""<f pelf
~to 5{? (1./ ~oo Si,
OWNER
(Name)
(Phone) {.jq 7'" ::J.J>tY:?
(Address)
(Phone) !d9 ~ ,. 3d' r~
,
(Phone)
_ \o/fO/JlV
(Address)
.~-Roofing
OAlteration
ORe-Siding
o Porch
OAddition
o Deck
o New Construction
TYPE OF WORK
OUtility Connection
o Fireplace
OLower Level Finish
PROJECT COST IV ALUE (excluding land) $
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 prv....:..~J 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 property to perform ne~ded inspections.
X 'l11~ ~_~
Signature
L-j-q-(l4
Date
~/~3/'7S
Contractor's License No.
$
$
$
$
$
$
$
$
1$ -;,.00
#
#
Park Support Fee
SAC
I Permit Valuation
I Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
2,svt>,V't)
$ 74. 7 r.
$ -
$ /. JV
$
$
$
$
$
I WaterMeter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
Builder's Deposit
Other
#
#
I TOTAL DUE
I Paid '7 V .(J7J
I Date ~,;(',j~ 'Z-
,
. ReceiptW ~'70
By /IP'v
/
This Application Becomes Your Building Permit When A..... _'ed
Jtil4!. ,/ 4 - q - 07.-
Date
Building Official
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 k......u...ry 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 aU inspections (952) 447-9850, tax (95i) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Planning Director
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/S- L( ell
I?r-e e z- V
- CONTR. /
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~~NSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~O MECHFIN~
/Ce,/OO r
COMMENTS:
A n
,// / /
/4"r
DATE TillE
Ij/~r
/I
tJ,.:2 -.If?
o EXIGRADlFILLING
o COMPUINT
o FIREPUCE RI
o FIREPUCE FINAL
o GASUNE AIR TST
o
// / I
~~#l /& T<-
,
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~';;6rR REINSPECTION BEFORE COVERING
Inspector: / I'/' ~ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
_n
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH & SAFETY/