HomeMy WebLinkAboutBldg Permit 02-1590
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ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yellow Applicant
Date Rec' d
PERMITNO.()~ -/~9()
&185- /'-107/1 .s-;-
LEGAL DESCRLt'TlON (office use only)
LOTjOBLOCK I ADDITION ~ J1!Cb-Hn 1;711
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(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
ZONING (office use)
,121
PID067~I/-Olo-O
T SM ,rrl-
1,2-- ZZ-b -C:, ~ "r
(Phone)
(Phone)
o New Construction
~e-ROOfing
DAlteration
ORe-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 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 the property to perform needed inspections.
S- ~ .5:
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I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
ODeck
OPorch
OLower Level Finish
o Fireplace
DAddition
PROJECT COST IV ALUE (excluding land) $
.P
Contractor's License No.
.:J SO{)....-'
$ ~7Iftf~
$ I:)-~
$ .
$
$
$
$
$
Park Support Fee
SAC
#
#
I 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 TOTALDUE
#
#
~
This Application Becomes Your Building Permit When Approved
Paid 7 ( /'J .-
Date!::J.. - I ~ -9-
Building Official
Date
I '2..-1 )-~:,).
$
$
$
$
$
$
$
$
$ '7b~--
Receipt No. i/ -1lJu 3
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
DATE TIME
CITY OF PRIOR LAKE J ., ~ ~L/
INSPECTION NOTICE SCHEDULED o/~lc;-
ADDRESS ~7?0 /M#S!
PHONE NO.
OWNER CONTR.
PERMIT NO.
02 -4"'70
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
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o SITE INSPECTION
COMMENTS:
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o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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iWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl