HomeMy WebLinkAboutBuilding 03-0529
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
29/7
-
j- D)'
-(,., " I
Date Rec' d
3-5-(JJ
White File I PERMIT NO I
Pink City . /') ? _ 01 C7"? CI
Yellow Applicant (,,(..-) ~ c.- L
ZONING (office use)
"..;vJ
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
.JD~I"I
g~'
(Address)
(Phone)
QS2 - 44S- 550 8
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
o New Construction
ORe-Siding
TYPE OF WORK
~eck
o Fireplace
OLower Level Finish
o Misc.
o Porch
ORe-Roofing
OAddition
o Alteration
OUtiIiry Connection
PROJECT COST IV ALUE (excluding land) $
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 properry 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 ciry official or a designee may
enter u:o~erform needed inspections.
X ~~ _ _ 5/~'~3
Signature Contractor's License No. ate
Permit Valuation Lf l)()O ~ry
Permit Fee $ , q7 ,).~
Plan Check Fee $ G1.J-I
State Surcharge $ 1- 00
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
e mes Your Building Permit When Approved
S:-~-01
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ ICJ..,4b
Paid
Date
11 ttt-'~6
I ~;ce~ ljil SILl
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
lanner constirutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
K-rad
R OrdC l-f ttr/..Jddr-.
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
when Si~/? .bY.' j Ci
ISSUed., 11/(
)- )--03
~
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS 29/ 7 Fax -paq / L IV tJ
TYPE OF WORK f)b~.
USE OF BUILDING ~ IlIL
PERMIT NO. OS --6SZr ' DATE ISSUED 55.03
BUILDER /Sun.,Ff7C - PHONE # -+45 -SSV8
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
I CTOR
FOOTING
PLACE NO CONCRETE UNTIL
._ I
~
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
DATE
5-~
VE HAS BEEN SIGNED
I
I~
I FINAL
.,
.,