HomeMy WebLinkAboutBuilding 05-1072
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
/J J7 AND UTILITY CONNECTION PERMIT
71.1/ CI:~
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Date Rec' d
White
Pmk
Yellow
I PERMIT NO. e5- '012--1
File
CIty
Applicant
LEGAL DESCRIPTION (office use only)
BLOCK 3 ADDITION C!.
LOT
OWNER
(Name)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
~f
ZONING (office use)
I~
\ D~6-"
(Phone)
5.-'F
(Phone)
(Phone)
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{p ldo .. ftJ'-bS - JoIa~
TYPE OF WORK 0 New Construction ~eck OPorch ORe-Roofing
OAdditlOn OAlteration o Utility ConnectIon
ORe-Siding OLower Level Finish 0 Fireplace
;:)~D ~. (.~~r
CODE: DI.R.C. DI.B.c. ~ Mise.
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5
PROJECT COST/VALUE $
(excluding land)
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 authonze,! agent tlll" the
above-menl1oned property and that all constructlOn will conform to all eXistIng state and local laws and will proceed in accordance with submitted plans. I am aware that the buildIng
ofliciaI can re~Just cause Furth. ermore, I hereby agree that the City official or a deSignee may enter upon the property to perform neejed Ins:ctlons..
X b- ~~(G~~ _ __~~q, . 0 ~5-o<;;
Signature ' Contrac or's LIcense No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
$
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1", $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ \ 41 . \\
\
Paid
Date
\~Wk
Receipt No. 9=>~~ce>
By (L.-DIA-
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. TIllS document
when signed by the City Planner constItutes a temporary Certificate of ZonlOg compliance and allows construcl1on to commence Before occupancy, a CertIficate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ("31~ V{C,"\ct-A CUlz-vE
TYPE OF WORK DC-~
USE OF BUILDING (2.eS A-/rz-
PERMIT NO. oc;- l~i2- DATE ISSUED {ohs/os
BUILDER J'v104J-nJ-' t- ^'<pc.... PHONE # h12- '85'"- \cC,;.e
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING '" C- vA... to
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN
l.fn. ....lldl; I I
I
I FINAL
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11./ rZ, /6 V
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FOR ALL INSPECTIONS (952) 447-9850
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9~Z.,4-B =1~dED GAFiAGE f"..."--Ivf'i c.l..l::.vAi H...._...
:::: BASEMENT FLOOR ELEVATION
"35.ft3 = TOP OF FOUNDATION ELEVATION
LOT AR6Z4 :: J +, tJe, 7 ~. Pr.
f-Iou~ AReA. I, 84-1 -ScPo pr.
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SCALE: l' . 30'
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[ hereby certify that this is a true and correct representation of a traot ot
Land as shown and described hereon. AS prepared by me thie ~7W day of
~8Ot-. 19.iL.
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Minn. Reg. No. 11(>efo
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