HomeMy WebLinkAboutBuilding Permit 03-1032
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICAtE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(please type or print and si2ll at bottom)
ADDRESS S 20 'I
1. White File
2. Pink City
J. Yellow Applicant
Date Rec' d
PERMIt NO.a3 - 11)8d-,-
ZONING (ofticeuse)
/?I SD
!fo /)(' 5 f
LEGAL DESCRIPTION (office use only) . . /, _ ~ Ie-
LOT BLOCK ADDmON Is..; ~ Jij ~ u;:x;xi p~-l?30-t?t'5~
g;'::e~R ~''A J /J"11Jef Lof~
SlOt{ 1101' 51 PIYor !Aft',
~~~R M ;;),).J,j,./ f Jr-dr'"o/ Co-
(Contact Name) Boh (' o (!//15 /
(Address) O/OQ L I /, A S
Dh -'YI/1AfPfL /1vl'_ -
(Address)
TYPE OF WORK
o New Construction
o Deck
OLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) S
15,5/)0.00
o Misc.
(Phone)
952- 't!f!J-7(; 1/
5537:<
11111
(Phone) 3,52- t' 8r-~
(Phone) q5"2-212-tg8!L/
8 f()()~,c1111 fo,.. I /f A/ SSl/20
~ f-
o Porch
ORe-Roofing
OAlteration
~-Siding
OUtility 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 property and that all construction will con;uu.u 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
;teruponth~%d~ns. 20()01F/Z 7-3({):3
(....../" Signi.tur:4(J ,/ Contractor's License No. Date
l/
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Pcuuit Fee
,;:(500. ---
$ ?tl7s-'
$ /, CJS-
$
$
$
$
$
$
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Al'l'& u led
Building Official
Date
OAddition
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
-'
17~. ,,-
Receipt No. ifij f'f3
By () r~
0\
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.
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer IW ater Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
TOTAL DUE
,-
Paid F /.L" ~
Date j{.,,;;;- - ~ 6
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE nME
SCHEDULED
n ~ '50
.-e~
ADDRESS ~. 0'-1
lk~
s+
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
CONTR.
e- '~~
PERMIT NO. . '\' - ~C~t -:- .n2
o PLUMBING RI (!ItA.."rI&. ING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
:Bt.PLUMBING FIN~t.uJ~ 0 ~SlJNE AIR TST
o MECH FINAL I'e.~;j!{ ~J &,' \.Va
<oJ
o(
w~~
~t~ ok.
d
- ~ "' ,.A~
~,
i- WORK SATISFACTORY. PROCEED
D. CORRECT ACTION AND PROCEED
~RRECT WORK. CALL FOR REINSPECTION BEFORE COVERING
Inspector. D'/~ Owner/Contr:
CALL ~..se ~o F THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIRE. 'ENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
I/fSNOn
~
03-103 .
\",