HomeMy WebLinkAboutBuilding 05-0084
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE. .
AND UTILITY CONNECTION PERMIT
Date Rec'd
/, z.D,Cl5'
~. ':.te ~~ I PERMIT NO. 0 ~ 00 174- I
J Yellow AjlfIlicoM . ....-J .
(P1eue type or print IIIId sian at 1Iottom)
I ADDRESS
.5 2> B (0 ..SHOf2J;.
TlL\..-
NE
ZONING (oIfice lilt)
;eISO
LEGAL DESCRIPTION (office ure only)
LOT / BLOCK I ADDITION .::rEPft:;tJOrJ-S /.g-
1::.=
. (Address)
PID itS. 2.-81. aoZ- . 0
\J\~ ~~~n=lL,)
SAM'.
(Phone) 9Ei2 -4+5 -llcClL I
BUn..DElt
(Company Name) Cu,,)tJ~
(Contact Name)
(Address)
(phone)
(Phone)
TYPE OF WOIlK. 0 New Construction ODeck Ol'orch ORe.Roofing ORc-Siding OLower Levd Fimsh 0 Fireplace ,
OAddition Ii)Alteration OUtilityConnection 0 Misc. ~Ll<;; _ Y\l\-c..A.{){2.eo-w- ~ G~~ \...lI'J II t-E~~
CODE: ~.R.C. OI.B.C. PROJECTCOST/VALUE S
Type of ~~0Jl: I D m IV V A B (excluding land)
Occupancy Group: A B E FBI M R S U
DmJion: 1 2 3 4 5
I hereby certilY Ihall have furnished information 011 this app1ication whicb illO the best of lIlY know1a\al: true and correct. I also certilY that I am tile owner Ill" authoritrd apt for the
above.mentlOllEd ' that all construction wiD conform 10 all exiltins state and local laws and will proceed in accordance with submitted plans. I am aware: that the buildin.
official can revoke is It for jus! cault. PIUthermorc:. I herdly qrtt that the city official or a cbignec: may enter upon the property to perform ~ Insp<<tions.
x
Contractor'1 Lic:enre No.
Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee 00.'
Mechanical Permit FeeGt\L1;.,E5
Sewer Ii: Water Permit Pee
Gas Fireplace Permit Fee
Parle Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
SewerIWater Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ /2/. 7S-
Thi. Appliution Become. Y 0lQ' 81IiIdlnl Permit When ApproYe'
~omc~ ~(;~!o:;
I Rece~o. -f~~ 70
By 'tff// .
I Paid /21. 7~
. Date I. ze .05"
nus ill 10 certilY that the request in the above application and aceompanyinl documents iI in accordance witb the: CiIy Zonina Ordinana and may proceed as reqUCSled. This document
when sipc:d by the City Planner cOIIStitutcs a rc:mporary Certillcatc: of Zonina compliancl: and allows constrllCtion to _. 1ldorc: oa:upancy. a Ccniflate of 0ccupInc:y IIIIISt be
issued
PIInnina Direclor
Date Special Conditions, if IDV
24 hODr notier for allln.pedloRI (952) ....'-98!!G. fn (m) ....'...245
16200 Eagle Creek Avenue Prior Lake. MN 55372
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING .
PERMIT NO. .r. (J5"J,O~ DATE ISSUED
CONTRACTOR -lLl~ ~~TQ2.$ PH NE ~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
--~:
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
H - INS
.
DATE
3-J,-.5-.fh-
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