HomeMy WebLinkAboutBldg Permit 03-0846
Date ...
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and siltll at bu.."~)
ADDRESS
I. White File
2. Pink City
3. Y e\low Applicant
I PERMIT NO.tJ3 - ~ '-I ~
~ 'i9J-
fI~~
Sf-
LEGAL DESCRIPTION (office use only)
LOT 1 BLOCK ~ ADDITION P ~ $~
OWNER
(Name)
-/~~
/h1.-~
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o New Construction
ODeck
OLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
OAddition
o Misc.
ZONING (office use)
)l?J5lJ
PID';>S- () /,- / /3-l,)
. (Phone)
(Phone)
(Phone)
o Porch
ARe-Roofing
OAlteration
?4-j.- ~ l./"';> .Y.:I-(
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 th~ pe~rm needed inspections.
X ~/~ ~.-. t'"'7S--,q3
.- Signature Contractor's License No. Date
I Permit Valuation
Permit Fee
Plan Check Fee
I State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
;}S (){),--'
$ 7l4,. '15
$ "OlS'
$
$
$
$
$
$
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
Building Official
Date
r Park Support Fee
SAC
#
#
. $
$
$
$
$
$
$
$
$ 7IP,~-
Receipt Nc::O ~ - g q "
By (f--'--
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"; I";
I Pressure Reducer
City SAC and WAC
Water Tower Fee
I Builder's Deposit
Other
#
#
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
TOTAL DUE
I Paid
I Date
----
1j ~j~,.
I, -~'::>-- ~
CITY OF PRIOR LAKE
INSPECTION NOT~!..__
SCHEDULED
DATE nilE
~- .J-G
ADDRESS
I;: ~q L l+rl/c~~~ P <; ,r
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
~
, ~ /
~
-------
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
r~ - rotf
..-
/
"3-?~ "
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
-...........
[- ~ /
I
-
~SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: JW g".j,tr(() Owner/Contr:
~
CALL 447-9850 FOR TH~ NE~T IN~PECnON 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
UtSNOTl