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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
File
City
Applicant
I PERMIT NO. !)"5-601'J
White
Pink
Yellow
LEGAL DESCRIPTION (office use only)
LOTL/taLOCK q ADDITION
(~ Ult~
PID3S
OWNER
(Name) ·
(Phone)
9S;J-;2';)l~ 399J.
~J 71.
(Address)
,1 (I'l
ZONING (office use)
16(:)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
~~- ~
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding
OAddition OAlteration OUtility ConnectIOn
------.,
ower Level FinIsh 0 Fireplace
CODE: fI.R.C. DI.B.C. o Misc.
Type of onstruction: 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 IV ALUE $
(excluding land)
I hereby certify that I have filrmshed Information on this application which is to the best of my knowledge true and correct. I also certIfy that I am the owner or authOrize,! agent Il)r the
above-mcot!oned property and that all construct! n will conllJrm to all eXistIng state and local laws and will proceed in accordance with submitted plans. I am aware that the buildIng
offieial can revoke ~mIt for Just cause er e, I hereby agree that the CIty official or a deSignee may enter upon the properry to perform needed Inspe Ions
x
Contractor's License No.
Permit Valuation
Park Support Fee
#
#
Permit Fee
Plan Check Fee
SAC
Water Meter Size 5/8"; I";
State Surcharge
Penalty
Plumbing Permit Fee se-l
Mechanical Permit Fee
, SO
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
LjtJ,.-
1~:~7
This Application Becomes Your Building Permit When Approved
~~~
I BUlldlllg Oflicial
Paid
Date
7/7/oS-
1)atc
$
$
$
$
$
$
$
$
$
ThIS IS to ccrtlfy that the requcst in the above applicatIOn and accompanYIng documents IS In accordance With the City Zoning Ordinance and may procced as requcstcd 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
Special Conditions, if any
Planning Director
Date
24 hOllr notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
PRIOR LAKE
INSPECTION -RECORD
SITE ADDRESS /.s~Sa. Ltx:Jad---1)u..<."k.;;'
NATURE OF WORK l."
USE OF BUILDING
PERMIT NO. DATE ISSUED 7-7-
CONTRACTOR? PHONE ;;.x,,-3~a.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
- I
I) I I
PLACE NO CONCRETE 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
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 b~en approved. On buildings and additions
where no service cabinet is available, card- snail be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850