HomeMy WebLinkAboutBuilding 04-0006
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/, 0,04-
00. ()547
IS~75
LIJ
fJLJ
Dr'ooK) I' \:
White File I PERMIT NO I
Pink City '04-, 000/
Yellow Applicant , \t' ,
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
s telJ-f .'\
-l...) VY...
(Address)
(Phone)
PIDZS,3C,'7 02-( .0
U Z 5(c ,c) c 7r-'.> .9-1
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction DDeck DPorch ORe-Roofing
~ower Level F.inish 0 Fireplace OAddition OAlteration
/ '\ .5'ftel~T ~C-K-
PROJECT COST IV ALUE (excluding land) $
o Mise.
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
;'''"POO mep,~pe~Tam ~ () [ 05"- 0 9-
'A""~ . Contractor's License No. Date
Permit Valuation
Permit Fee $ - J - L" '/ z l2
, ., v,
Plan Check Fee $ -
State Surcharge $ ~~-/.l
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Building Official
Date
()
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
City SAC and WAC # $
Water Tower Fee # $
Builder's Deposit $
Other $ /;,., -?7. L~
TOTAL DUE $ 'r5-. .&.:::s-
~
~ d ' 0>'-)-
1- '5 -04
I ~:;iPtNOr;: 8",,5
Paid
Date
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.
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
Planning Director
PRIOR LAKE
INSPECTION RECORD
LJ
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /..s-S7 S- B /UJ7)K-r1 t! E:
NATURE OF WORK ?OW GJL L,evt:/~
USE OF BUILDING /ZeI (J/ ~
PERMIT NO. 0 4-. (no ((/ DATE ISSUED 1_ s:-. 0 ~I
CONTRACTOR ,77/;v/{3 PHONE (p/Z.s2S-.74-s-4-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~ I
I F I i
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
- DATE
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 been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850