HomeMy WebLinkAboutBuilding 04-0944
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
r
~
Date Rec' d
t:t. z.tJ.04-
White
Pink
Yellow
I PERMIT NO. or-09 rr I
File
City
Applicant
ZONING (office use)
5:€'
.
LEGAL DESCRIPTION (office use only)
.fit. ,
LOT 'te BLOCK , ADDITION C; t6 .bD\Tf L'N
PID
OWNER
(Name)
(Address)
6e.t:<R4
d(,ult
BUILDER
(Company Name)
(Contact Name)
(Address)
.,...,5
4-bo'.- e:
~ 111<<. e
(Phone)
rs).. - 4ft) -/21 ?
J1 ;J /]63 "77--
----
\Jt
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish
OAddition OAlteration OUtility Connection ~MiSC6;r/HeS;.w ~ec;::<
PROJECT COST /V ALUE $
(excluding land)
CODE: g.R.C. DI.B.c.
Type of &nstroction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV
H I
2 3
V
M
4
o Fireplace
,.
/ ~tJ 0
.
A
R
5
B
S U
I hereby certify that I have furnished mformatIon 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
tlOn will conform to all existIng state and local laws and will proceed in accordance with submItted plans. I am aware that the buildmg
Irthermore, I hereby agree that the CIty official or a deSIgnee may enter upon the property to perform needed mspectIons
abOVe-mentIon~:~/:roperty and. tha. t all constr
~ticial can re j z~er;;ust cause _
Signature
L-
Permit Valuation I!(I~()O, lJo
Permit Fee $ L/(.ZS
Plan Check Fee $ ~I..D .~I
State Surcharge $ ,S-O
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
BuildllH~ Ollicial
9/~:y
Da
Contractor's License No.
r ,-21) '-0 1-
Date
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 $ 68, '5~
I' Paid
Date
'7;;' ~~
I ~;Cei~?J/lr
ThIS IS to certify that the request 10 the above applicatIon and accompany 109 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 CertIficate of Occupancy must bc
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspeetions (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
PRIOR lAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
ECORD
SITE ADDRESS ~ 3te, ~ Jt.Fj~ I
TYPE OF WORK .D~~ n ~:L;
USE OF BUILDING S..1=;_ .
PERMIT NO. ~~ DATE ISSUED
BUILDER t//~~ ~ P NE -""'-/217
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
.
S:E.,
~ NO CONCRETE UNt'L AB~:E:O:AS B~EN SI~':ED ] .
-. ,. r J
I FINAL I vtV!' r ?17'7J:p;
FOR ALL INSPECTIONS (952) 447-9850
,..