HomeMy WebLinkAboutBldg Permit 02-0173
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
2-2-/-02-
1. White File
2. Pink City
3. Ye\low Applicant
PERMIT NO. 02---01'13
(Please type or print and siltll at bottom)
ADDRESS
3lj;55 /3/1SSWOOO
(!/ IZrU-E
ZONING (office use)
;21
LEGAL DESCRu' llON (office use only)
LOT 17BLOCK 4- ADDITION N//.,vOWS
0WNER 71 L I
(Name) ~!:> l.A n (jf " Yl
3'55- g" J~ '" Dod
~7Ji ftDON.
PID Z5 - z4-f;- ()~ fJ - 0
(Phone)
~ /1. 'fJ 9 Y- '17 '1
\ (Address)
'-
( ,'r
~ lA../
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
o Deck
o Porch
OAddition
~ROOfing
OAlteration
ORe-Siding
OLower Level Finish
o Fireplace
OUtility Connection
o Misc.
PROJECTCOST/VALUE (exc1udingland) $
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 fo above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans a ~ware th;r building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon th reo pe eded inspections. 2/ z.../ Ii) L
X L. .\ /
. , / }<:lignatute Contractor's License No. ~ate
/ f - I
I Permit Valuation / Z I 5" 0 0 . () 0 I Park Support Fee # $
I PermitFee $ 74: 7r I SAC # $
Plan Check Fee $ I Water Meter Size 5/8"; I"; $
State Surcharge $ I . z...) I Pressure Reducer $
Penalty $ I Sewer/Water Connection Fee # $
I Plumbing Permit Fee $ I Water Tower Fee # $
I Mechanical Permit Fee $ I Builder's Deposit $
I Sewer & Water Permit Fee $ lather $
I Gas Fireplace Permit Fee $ I TOTAL DUE $ '7 (p .00
~
v z"J -07.-
I Paid
I Date
~(g . 0 0
z- ?-. / -0""2--'
Rec.,,'pi 1Ii?-3 q
By J ~ .
,
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
16200 Eagle Creek Avenue Prior Lake, MN 55372
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
OWNER
3655
BASSWOOD
02-0173
Re- Roof
ADDRESS
PHONE NO.
o FOOTING
o FOUHDA TIOH
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUmtslNU ".
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o flLUMBING FINAL
o MECH FINAL
_ -XlGRAD/fILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
Cl05~ F!lE
Mfke--Rel ""I .;)VII, Duitding Insp~ctor
nEt 2 Z003
o WORK 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 &: SAFETYI
INSNon