HomeMy WebLinkAboutBldg Permit 02-0218
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERn.nCATE OF ZONING COMPLIANCE
,
AND l.JnLITY CONNECTION PERMIT
...
(Pleore """ "'orint...... "......_1 ~ 1fOJ.' 5001-
ADDRESS ;( ~5"). Sj ri"j lAke.CJa:J<J. 5UJ
Prior ~Q,..., ~J ___'5'"531)-
Date Rec' d
/
I. White FiI.
2. Pink City
3. Y.llow Applicant
LOT
BLOCK
. LEGAL DESCRil' uON (office use only)
ADDITION
PID CJ5-/3?>.;05Q- J
ZONING (office use)
RJSD
(Phone) 9.5) - '7'-10 ~ 6305'
OWNER/l'J V ok .
(Name)-.-J.;1era! .J.. An'S Zts'ovskj
(Address) ..{95~ Sfdn3 L1 k. ~(.fId 5liJ)
BUILDER 5- . r*_ __L' C
(Name) _ dn~u. l.1l115J ruch On ,) :r;" c..
(Contact Name) I/J~/)~ $Jnd::Ju....-
(Address) 3010 6sr ~ Au~ Sh;;knpee. t mrv 55377
TYPE OF WORK
o Misc.
Pr//Jr bke, mil! 3~57;)-
(Phone) '152- - ~~3'" 'flot)
(I4leftef~51'" t!o3 - WO
o New Construction
ODeck
OPorch
ORe-Roofing
-sRe-Siding
OLower Level Finish
o Fireplace OAddition OAlteration OUtility Connection
PROJECf COST IV ALUE (excluding land) ~ 9B'l7o .:v-
Signature
Contractor's License No.
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
aUthOriZ~d a~ep. t for the a e-men. tioned property and that all construction will conform to all existing state and 10ca1laws and will proceed in accordance with
submitted arl/l. I w e that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upo pejPro / t no needed inspections.
X . It..' Be. - 7J..5'1 o~-')'7-O?-
,.;v
Permit Valuation
Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
I ;)SotJ.OO
I $ 'Jr;_ fJJ5
'$ i/~
$
$
$
$
$
$
I Park Support Fee
SAC
#
#
WaterMeter SizeS/S"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
Builder's Deposit
Other
#
#
I TOTALDUE
I Paid tI'1" ,t)O
I Date 3 - ~ ,. 0 0-.....
Date
. $
$
$
$
$
$
$
$
$ tfo ,0'0
I Receiot No.4'1 )-k'b
I B'!r~' -
This Application Becomes Your Building Permit When Approved
Building Official
Date
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SGHEDULED
ADDRESS
,:}9S~
+1Li~~
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATIO~ 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
1!! FINAL 0 PLUMBING FINAL
o SITE INSPEC I. 0 MECH FINAL
COMMENTS: '~D/~
,,/If.,.
~~
DATE TIME
fL'Sfo t.
Ri..
A~c.
02. - zt~
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
)f. WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~ORK CALL FOR REINSPECTION BEFORE COVERING
Inspector: _ Owner/Contr:
I' -
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSlVOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl