HomeMy WebLinkAboutBuilding 04-0495
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
s: ZS. 64-
File
City
Applicant
I PERMIT NO. 04. OH.s-1
White
Pink
Yellow
(Please at bottom)
ADDRESS
/&9~/ ..5lnp/c/NS
C I Ie (!, (,.,,6
sw
LEGAL DESCRIPTION (office use only)
LOT 2. BLOCK & ADDITION / sr /l.DOA./. 7lJ W6ST8u.
ZONING (office use)
1</
PONDS PID25.308. 032..0
I07TH6/e.1N6
I
OWNER
(Name)
C':/teOSK'-/1 qs
(Phone)
Cf5~- f./YD--7 '0 3
95;). - '190'- (09/9
I-I-tn
ClolCAl--
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction
OAddition OAlter 10
Deck OPorch ORe-Roofing ORe-Siding
OUtility ConnectIOn 0 Misc,
OLower Level Finish
CODE: 1SIII.R.C. OI.B.C.
Type of ~nstruction:
Occupancy Group: A B
Division:
B
S U
PROJECT COST IV ALUE $
(excluding land)
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
o Fireplace
I hereby certity that I have furnished mformatlOn on this applicatf' which is to the best of my knowledge true and correct, I also certtfy that I am the owner or authonzed agent for the
above-menttoned property and that all construction will conform to a xisting statc and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
:fi'"'" ,~ . "'.i, ".m" '"' .'" CO,," :""" =". , 00"" ","' "" ,", '" ..ffi,.' "'" "",,"0 m.. ,m" .,,,.. cli, "",,,,,,.. ",.'",m ""51.24-/0 1-
Contractor's LIcense No , D~
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"; 1";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
~~
Buildll1~ OffiCial
sjZS" (0<(
Date
$
$
$
$
$
$
$
$
$
ThlS tS to certify that the request in the above applicatIOn and accompanying documents is m accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
when signed by the Ctty Planner constllutes a temporary Certificate of Zoning compliance and allows construction to Commence. Before occupancy, a Certtficate of Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any
-\.'.:,:..,--.,.."
C,: ;;.- _,' __ _,~' '_
\
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS IlD Cl~J S~.s. c.L Ie C<.e
TYPE OF WORK J)EC/C.
USE OF BUILDING S, F=:' p, .
PERMIT NO. 0 ~ - ""'S DATE ISSUED S/Z 5 J 04/
BUILDER c.?Rdr.KLA6S PHONE# ~-;1"()3
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOnNG I I
IIIIIiIiiiiiIIRETE UNTIL ABOVE HAS BEEN SIGNED
I I
I FINAL
r
f
,
FOR ALL INSPECTIONS (952) 447-9858