HomeMy WebLinkAboutBuilding 04-0837
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
8. 13. O~
File
City
Applicant
I PERMIT NO. 0 If. O~3 7 I
White
Pink
Yellow
ZONING (office use)
K:.z-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID zs. q(lz'. (110. 0
OWNER_
(Name) ,~--r R.\ c..t..H c:::-
(Phone) qsa-Lt4 7-:J. 9 f '-f
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction RlDeck Porch ORe-Roofing
OAddition OAlteration OUtility Connection 0 Misc.
e-Siding OLower Level Finish 0 Fireplace
CODE: ~.R.C. DI.B.c.
Type ofJ:o~struction:
Occupancy Group: A B
Division:
B
S U
PROJECT COST/VALUE $ 4, Lbo. 00
(excluding land)
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
I hereby certity that I have furnIshed Information on this application which IS to the best of my knowledge true and correct. I also certlty that I am the owner or authonzed agent for the
above-mentIoned property and that all constructlOn 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 Ihls permIt for Just cause Furthermore, I hereby agree that the CIty official or a designee may enter upon the property to perform needed inspectIOns
X ~~ 8-Il-oLf_
f Signature Contractor's License No. Date
Permit Valuation Park Support Fee
Permit Fee $ SAC
Plan Check Fee $ Water Meter Size 5/8"; I";
State Surcharge $ Pressure Reducer
Penalty $ Sewer/Water Connection Fee
Plumbing Permit Fee $ Water Tower Fee
Mechanical Permit Fee $ Builder's Deposit
Sewer & Water Permit Fee $ Other
Gas Fireplace Permit Fee $ TOTAL DUE
#
#
#
#
This Application Becomes Your Building Pennit When Approved
~~
8ft rtfJ t/
Buildll1!! OfIlcial
$
$
$
$
$
$
$
$
$
ThIS IS to certlty that the request In the above applicalion and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
when signed by the Cily Planner conslitutes a temporary Certificate of Zoning compliance and allows constructIon to commence Before occupancy, a Certtficate of Occupancy must be
issued
Special Conditions, if any
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
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PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS ~t? DO ~r 1Z1e-1f:: /2L).
TYPE OF WORK DE~ / --'fLCH __ /26.51 Db
USE OF BUILDING IZf3s I /1/1<.
PERMIT NO. fJ4. () 637 / DATE ISSUED 11. /3.04-
BUILDER !/U(!fiIE PHONE# 447. 217+-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING I f!H frJ I '1 /r./~1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SfGN'EC
. FRAMING
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FINAL
FOR ALL INSPECTIONS (952) 447-9850