HomeMy WebLinkAboutBuilding 02-0428
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
4S<rs- Hu~~/~ i",;I Tv-~;I
Date Rec' d
4- ' tit ,.f) r
I. White File I PERMIT NO I
2. Pink City . 0 ? -0 ..I ,'7 LA
3. Yellow Applicant . V q- ~ .
AlE.
ZONING (office use)
LEGAL DESCRIPTION (office use on~) L:I/ I /' / '
2. I k...cob 11,'11;> AJoI/~'t:r"'
LOT BLOCK ADDITION
PID 25 . 3'-1-1- 6 {} 7- - 0
OWNER
(Name)
~....d
D4II4!
(Address) Sc::;. "'-e
Al440.CY
Ge.J.L-
(Phone) r6'".2 - '(4 ~ - 76-~Z
BUILDER
(Name)
..~~
(Contact Name)
(Address)
s,.IF
(Phone)
(Phone)
TYPE OF WORK
ORe-Siding
o New Construction
o Misc.
o Lower Level Finish
PROJECT COST /V ALUE (excluding land) $
l)i!t>eck
OPorch
OAddition
ORe-Roofing
OUtility Connection
o Fireplace
o Alteration
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 property 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 city official or a designee may
enter upon property to perform neede inspections.
x
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
$
omes Your Building Permit When Approved
V- 2(P -02-
Date
$
$
$
$
$
$
$
$
4--, $ Z..rf
I 'ii' L/~ I ReceiPtNO~ao q<Y I
_ ::J4- ~').-/ By gn
Contractor's License No.
Park Support Fee
#
Date
SAC
#
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
Water Meter
Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
Water Tower Fee
#
Builder's Deposit
Other
TOTAL DUE
Paid
Date
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
--
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS 45''15 I+UVldINl"IA{J Btrce Jr=
TYPE OF WORK }J.pLJ DP(""(c
.
USE OF BUILDING SW
PERMIT NO. 02 -O+Z-t2J DATE ISSUED 3-::? (~- C) C
BUILDER Gd2- PHONE # "'IS-2 - <{o~ -'i.~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR DATE
I FOOTING I 6-:r. 15/c19102-- I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN S'IGNED
I~ I I I
I FINAL I fff I {-1-'6-0) I
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850