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ADDRESS
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER 0
(Name) 1'\ tJ k ...
(Address) / (;, I'S" I
ft)7/ (;;0 I~/ (.~
;Jt'/r'tJ//n"e C,.
/
I. White File
2. Pink City
3 . Yellow Applicant
(Phone)
,1M.!
BUILDER /~ A <-/) (,''./)
(Name)~/) V'/VC (OAJ17c'/9u:fi/v G=-
(Contact Name) _ Ed' Llj~'1.r/Cf- / /Az-z i/f#C"Pf
(Address) .$ ~?i &tr:J/a-./t:2l~C. (!/t'6..//et
TYPE OF WORK
o Misc.
o New Construction
OLower Level Finish
Date Rec' d
~ -..l c-07
PERMIT NO. CJJ- Oriy
ZONING (office use)
/2-/
PID ZS--3tJ8 -uU-O
1r;} - C;VIJ'- ra919
_ (Phone) (}07~ ?9"'/~?'?
(Phone)
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DDeck
o Porch
ORe-Roofing
)dAlteratiOn
o Fireplace
DAddition
ORe-Siding
OUtility Connection
I hereby certifY that I ..l1a'\ie fumi hed 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 ..the abov entioned roperty and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plan am a e that i :..: '"u '~Y'je this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon th rop 0 perfo ons.
X ----.. ~-.fO "'OJ>
Contractor's License No. Date
I Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
PROJECT COST IV ALUE (excluding land) $
$
$
$
$
$
$
$
$
#~oa() , 00
,-~q, 7<:;
,.81 ()
This Application Becomes Your Building Permit When Approved
~-:f~
Building Official
#.,g"jtJ3
/ Date
I Park Support Fee
I SAC
I WaterMeter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
Paid 35.2-!.-
Date .4 ,Jb -07
#
#
#
#
$
$
$
$
$
$
$
$
$ /? -- -
....:J..:;;. 2-6
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Receipt :ria. 4-/til
By r_"
(}
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
SCHEDULED
ADDRESS
/1, {r (
p~r< I','--I"'V(
} OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION / J
fi!f FINAL &-(...(
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
/3.1.fl-t 0 PLUMBING FINAL
o MECH FINAL
COMMENTS:
~ ------
/
/
/ , -
/ / I {)C,t ,
( (~tV- ~
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DATE TIME
(,-11
"'3 - Lff'f
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
"'-.. -.....
r J "j
'- J /
I (/ V
/'
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: 11/ C, /7.....0). Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSNOTI
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS / (p / g / /'?t;;7U 4/21 N C
NATURE OF WORK &. L- . e/~ m
USE OF BUILDING /&6S 11//0
PERMIT NO. 03 - () 4Cl4- /DATE ISSUED 4- -30 -03
CONTRACTOR OL-tJ LJLue PHONE 507. 744- 4238
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I
J
E UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
1N3ULATIOrq--
ELECTRICAL
PLUMBING
21/1//
c- it.
NJP
JIV(""
Gll
S - ft.;
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
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( ~ IrI
r
~ ~-(7
U1 /1/./
'v, - (~-(7
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
\
FOR ALL INSPECTIONS (952) 447-9850