HomeMy WebLinkAboutBldg Permit 02-0238
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADi$o 51Cl[~ €Mr,') lraiJ
LEGAL DESCRIPTION (office use only)
LOT \ BLOCK
OWNER
(Name)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o New Construction
OLower Level Finish
ec'd
I. White File
2. Pink City
3 . Yellow Applicant
I PERMIT NO.O
~z38
\if; I fn Or liL ~ I fO~ 69.J / 2-
(Phone)
(Phone)
o Deck
o Porch
~e-ROOfing
OAlteration
I ADDITION 0~~ N <; f\ (Z$5~ ,Avr'1 PID ZC:;- -"Z.& I ....a::;( .-'0
~~\{,1 n~n (Phone) ffSJ- a33 -lliJtJ
PROJECTCOST/VALUE (exdudingland) $
o Fireplace
OAddition
o Misc.
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
authorize 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
submitt lans. 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
enteru thy.~ ,~_~jtonrfOrmneededinSpectiOns.
X \ .11n .
i U1 Signature Contractor's License No. Date
Permit Valuation
~-
l+.f~
-z.'-i:X'., -
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
I Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
I Gas Fireplace Permit Fee $
~f),~ . ) ~ f ,1
ThUAwli<ivTf;:--;}(;/o7-d
BUilding Offici!u ~ / Date'
1,7-~
I Park Support Fee
I SAC
Water Meter Size 5/8"; I";
Pressure Reducer
I Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
lather
I TOTAL DUE
#
#
. $
$
$
$
$
$
$
$
$ 7~. -
Receipt No. 4\ 503
By (l.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.
#
#
I Paid
I Date
t\..:- ,
?/r'$/OZ-
I '
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
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
..,.i!HIINAL
o SITE INSPECTION
COMMENTS:
./1 II
/ar~r
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
a2 - ~JY
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/J -?/
(Ci)~ ~/~ re-
""
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector. ~ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY/
INSNOTl