HomeMy WebLinkAboutBuilding 05-0147
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
White
Pink
3 Yellow
File
City
Applicant
I PERMIT NO. ()5- /t(?1
at bottom)
ZONING (office use)
)(/
~50
Cir cie SvO
P r ;() V' Lttt:P J If} AJ 553
LEGAL DESCRIPTION (office use only)
LOT
ADDITION
rei
PID ~5-1/{)- 004
~'::e~R c,h.aJ <T /lncivt?()....
(Address) 36i)q g{lS'<;t(.h~Dd
/AiY)/)cAey
C',.,e Ie Sw P, I.""
99 -57&" -~.;) "')6
(Phone) ~/() -6tO- 7" 60 (jr-e 0
q)'-5~' 2-
La~
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
DAddition DAlteration DUtility ConnectIOn 0 Misc.
CODE: ~R.C. DI.B.c. PROJECT COST /V ALUE $
Type of onstruction: I II III IV V A B (excluding land)
Occupancy Group: A B E F H I M R S U -{ifcheN if hJdL
Division: 1 2 3 4 5
I hereby certify that I have hlrnlshed 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 ca.!"l.~. ke t.~.~. p;:jJll~~~st cause Furtherm~~~Ihe..rebY agree thot theClty official or a '1eSlgnee may enter upon the property to perform needed InspectIOns. "
X ~. . ./' .;;J. LU..... A-c.iW/~jlA--.. ? -I ~ --f' 5
/' Signatl:lre Contractor's License No, Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ ~, z..5
This Application Becomes Your Building Permit When Approved
~d~~
13uildlllt! Otliclal
Paid
Date
~~~- ~as--I
Receipt No-,tjRo 7t.
By
~~/o5
Date
ThIS IS to certify that the request III 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 Zoning compliance and allows construction to commence. Before occupancy, a Certlticate of Occupancy must be
isslIcd
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 .
SITE ADDRESS ~~a1 ~ AJOO() C/~ S.w.
TYPE OF WORK IfJl a!)I./4"" Jt./E1ADDCI-
,USE OF BUILDING S;,c;b.
PERMIT NO., DATE ISSUED J./;SpS
BUILDER f' U HONE #.I"~fJ -106.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~.I. INSPECTOR DATE
~~/WJ I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
FRAMING
,.,a",-,
FINAL
DEPARTMENT OF
BUILDING AND INSPECTION
FOR ALL INSPECTIONS (952) 447-9850