HomeMy WebLinkAboutBldg Permit 02-0090
_. Date Rec'd
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
..
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yellow Applicant
(Please type or print and sign at bULLVm)
ADDRESS
l/3 L/ ~ ~ 0 , 6 r ttJtJ S 1- ~ S. f3..
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER I I 'd ' <'"'7""" L ~
(Name) t'fC 1 \.... ~ OS'l r c-fCrS6n
(Address) /'/34' ~ 0 lorqul'D .S-I-. $_~.
BUILDER
(Name)
(Contact Name)
(Address)
PERMIT NO.
D'2 -00'7 ()
ZONING (office use)
PID
(Phone) q 52. 9/./0-""3 ~i.I()
SELA ROOFING & REMODELING, INC.
.uno EXCELSIOR :BT_l~.
ST. LOUIS PARK, MN 55416
W fWOO10DO
(Phone) C, 1'1, ~~3 - <(;;61../6
(Phone)
TYPE OF WORK
o Deck
o New Construction
o Fireplace
PROJECTCOST/VALUE (excluding land) $ "" S- 5'0..9-
OUtility Connection
o Misc.
OLower Level Finish
o Porch
OAddition
ORe-Roofing
r$Re-Siding
I hereby certify that I have ished 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 ~or th ab e-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted pi s. I a a 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 prop perform needed inspections.
X . ' I b ~ 6 1- ~ /, 1- 0 (
I ' Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee $
I Plan Check Fee $
I State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
~) /7 .
( ~ Yom """- p=itWh<n Appnw<d
I .LY(i.. 1-25-0<-
Buiidin~Official Date
.
2,~-oO.CO
79. 7S-
, ' '2.. cs-
OAlteration
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
I TOTAL DUE
I Paid
I Date 1#'2."" -0 2-
# $
# $
$
$
# $
# $
$
$
$
ReceiP~\ 'f"7~
Bv 1
..
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
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
DATE _TIME
SCHEDUlED
434-0 LOLO~O()
CONTR.
PERMIT NO.
z--0o90
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR RE.I~ECTION BEFORE COVERING
. It t/ -1..,- /5 _
Inspector: V IJY" / Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl
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