HomeMy WebLinkAboutBuilding Permit 03-0957
------
/
/ /- 1\ nct'
( (
"
v- -
,
---
~
1 ___ I'. J
( r. 'l
/
~
rn--wORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECTJlCt'RK. LL FOR REINSPECTlON BEFORE COVERING
g:,. I vlD
Inspector: Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
"""'>n
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CITY OF PRIOR LAKE BUILDING PE~IT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
7 . zJ (J]
I. White File I PERMIT NO I
2 Pi,k Ci<y . {)I:;:> _~ 0;:::1
3. Yellow Applicant ....J U I.....,.} I
(Please type or print and sign at bottom)
ADDRESS ZONING (offic,",,)
.3 7/S- / lO'l1?
Sf- S'
,0
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER .
(Name) IT .I2re"",/, il- 41, C'ln?/
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
DMisc.
(Phone)
(Phone)
(Phone)
D New Construction
DDeck
~e-ROofing
DAlteration
PIDZ5"~ 910.002.0
tJ...;;<~, Y~/5?
ORe-Siding
DUtility Connection
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 Y'~Y':'HJ 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 u9=. e propeny to perfrffi n;i'llI'r i~'necrinn< 7-;Z /.. //, ~
)( ,~~ ~!.~, /. <-, .,,-
r Signature '" Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
! State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
1 Gas Fireplace Permit Fee
DPorch
DLower Level Finish
o Fireplace
DAddition
PROJECT COST IV ALUE (excluding land) $
Park Support Fee
$
$
$
$
$
$
$
$
SAC
j Water Meter Size 5/8"; 1 ";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
~/I/? DU
-"];7-1 cJ?
f. .
This Application Becomes Your Building Permit When Approved
Building Official
Paid
Date
Date
# $
# $
$
$
# $
# $
$
$
$ 7 c,,_ (JO
(, ./
Receiv[!:.o. ~/y
By ,
C
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