HomeMy WebLinkAboutBuilding 04-0112
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
/ ~+-S9
~.J' J?E: C:,,-n-n:;,.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER ( L t; e - .-f'
(Name) V I ~ I
L \l (;,J D tl A<
Date Rec' d
'3. L.o4--
~. ~i~i~e ~::y 1 PERMIT NO.O~-. 0//2-1
3 Yellow Applicant .,..- _
wtty
ZONING (office use)
PID
. .JttJ,-. 0 z., , 0
(Phone)
u?> {{ C; (; I
Cf'1l-- $
(Address)
(0 I:J r; -~ v
1-)({ ltt,K
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
ORe-Siding
o Misc.
~ireplace OAddition o Alteration
PRJJE~T COST IV ALUE (excluding land) $
OUtility Connection
ODeck
o Porch
ORe-Roofing
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 age t 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 pi . 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 pro to perform needed inspections.
x
Signature
Permit Valuation
I, va O. 0 0
$ .:3 ;f-, 7 S-
$
$ 5"b
$
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee "
Mechanical Permit Fee
"""'0,00
Gas Fireplace Permit Fee
~o, () 0
This Application Becomes Your Building Permit When Approved
~ T./.ol-
Bu mg 0 cial Date
Contractor's License No.
'3/-2/ 0 '1
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ //5.z.5'
Paid
Date
/I~.vr
3. Z. ()~
I ~;reJfL~.u6
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
PRIOR LAKE
INSPECTION RECORD
#5 f TeM
L
DEPARTMENT OF
SUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING
PERMIT NO.
CONTRACTOR "'ISDN L)~ PHONE
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
.
! F: P.
INSPECTOR
DATE
ONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
L.. I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance. po
FOR ALL INSPECTIONS (952) 447-9850