HomeMy WebLinkAboutBuilding 02-0887
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
7-//1- 02-
{/i
I. White File
2 Pink City
3. Yellow Applicant
.t-i;
.~
'l
PERMIT NO. dt~oe'07
..............,
<.::,
ZONING (office use)
pt/.n
LEGAL DESCRIPTION (office use only)
LOT (p BLOCK / ADDITION ~/ N,
BUILDER_ ~ .
(Name) ~ Ok C-.O-~o..rr:.o~
(Contact Name) ~("- (<--
(Address) L\
OWNER
(N ame)
~\
(Address)
PID25~3C13- 00 - 0
(Phone)
41 ~-ez 4, l{ r--
.-i--
C Q\.'\) +-
(Phone)
(Phone)
G{J-14o~7'oCC
r
TYPE OF WORK
o New Construction
~
ORe-Siding
o Misc.
o Porch
ORe-Roofing
OLower Level Finish
o Fireplace
OAlteration
OUtility Connection
OAddition
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 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 u the pr erty to fomn.eeded inspections.
X "ILl ~~' L(<=eJ c:)' '+.,... ,'l --0-
Signature Contractor's Lcense No. Date
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
Water Meter Size5/S"; I";
Pressure Reducer
Park Support Fee
SAC
# $
# $
$
$
# $
# $
$
$
:1 "0 '].,/ $
I~~?:.
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Your Building Permit When Approved
.3?1-'7
7;z,.4-'V
1,22,crl-
Paid
Date
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 (95i) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
'"
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 3/00 WILDS R-IOq6 GT
TYPE OF WORK DF;(!A::::
USE OF BUILDING I26s ,q/I<-
,
PERMIT NO. 02-0887 DATE ISSUED -;--/9-02-
BUILDER (!As/J A.!OVA CON.sT;te... PHONE # ~ I z-. <7~(). 7/08
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FINAL
Call between 8:00 and 9:00 A.M. for all in
FOR ALL INSPECTIONS (952) 447-9850