HomeMy WebLinkAboutBuilding 04-0526
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(Please
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom)
Date Rec' d
I White
Pink
Yellow
~--!~otJ
I PERMIT NO. Of' ~ O~ZftJ I
File
City
Applicant
5/() 9' ~t)NOJE7J GE
L/17J 6
ZONING (office use)
R./
LEGAL DESCRIPTION (office use only)
LOT 9 BLOCK I ADDITION .a
67W-
PID 25". :3 99. 009. ()
OWNER
(Name) E.u~
(Phone)
<j52-22l~ ~441
(Address)
~~
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction
OAddition OAlter
CODE: MI.R.C. OI.B.C.
Type of &nstmction:
Occupancy Group: A B
Division:
Deck OPorch ORe-Roofing ORe-Siding
ion OUtility Connection 0 Misc.
o Fireplace
I
E
II
F
1
III IV VA
HIM R
2 3 4 5
OLower Level Finish
B
S U
PROJECT COST /V ALUE $
(excluding land)
I hereby certifY (hat I have nlrmshed mformation on this application which is to the best of my knowledge true and correct. I also certifY that I am the owner m authonzed agent for the
above-mentIOned property and that all construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans I am aware that the buildmg
oft!clal can revoke this permit for Just cause Furthermore, I hereby agree that the CIty official or a designee may enter upon the property to perform needed mspectlOns
x
~<.....,,~c""---=--=-'-.l ~..::-~~
Signature
0<:"/0\ lolt
Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When Approved
~~
Building Ollicial
~!fLot(
Contractor's License No.
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 0tt{E) (, .'2--,01- $ I '2..2.. to,
i.~,~q
',- l --0 if
I
I ~;C'~40g:)~
Paid
Date
This IS to certif)> that the request m the above application and accompanymg documents is m accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a CertIficate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Residential Building Permit Checklist
'-
D<;:d..: Addition.::; to SiIlsle F ~lmjly Home.::;
BY~
M~
Datc:
<::'- 1- 0 C;
BujJdins hrmit #
Site Addre:5S
PID:
,,~- ! i; 9-
,-/
'f) .' Zonmg: , _
l i~71ck~~jf
Subdivi.::;ion:
dlL/Y--~
Legal: L B
Exj:5ting Structure: YES or NO
CONFOR}IS TO ZOL''fE\G x'ES NO
ORDI0t-ANCE
Yar.d Secback:i: NOT .:\..PPLICABLE Requirement Propo:ied
MEETS CODE
. SIde Yard La'
(25' ifabuEting a stre~t, 30' ifabuttmg il street In 32.- I
C ardin~tl Rjdge)
. Side Yard 10' I
d-~
. Rear Yard 25' t _
lh/<.A 2S"
. T o wr..ho uses MuS! be consistenc willi
approved pb.n for NA
develop ment i
AN'! PROPOSED DECK NOT MJ:ETll'iG THE ABOVECRlTERlA MUST BE REFERRED TO THE
PLA1'fNlL"'\(G DEP,,,~...EnIYffi''fT. ALSO, ,,~"fY DECK 0['1 A LOT WTTH A SUSPECTED BLlrFF, OR ANY
OTHER UNUSUAL ClRClIMSTA..:-'1CE LVIUST BE REFERRED TO THE P1.A.i.....(NlJ.'1G DKPA.RTLYI:ENT,
T1iIs CHECKL1ST "vruST BECOMPLETED ...u'ffi INCLUDED li'l TEE BUllDD.'\fG PERi.'yllT FI1.E TO
LYIA.l1'fTAll'i A RECORD OF THE REVIEW..
- E)/i.Pr....~" E'DEC:~~==-:CX.DCC
./.< . .
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
flEq9fl
SITE ADDRESS
TYPE OF WORK
USE OF BUILDINj}
PERMIT NO. 0..,- DATE ISSUED
BUILDER "'().(Lu.- PHONE #~31.". fi rtfl
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
L.~
. IN~ fJATFf
I FOOTING I _ I ~/(i(/'i
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
, FRAMING I I
I FINAL I I
FOR ALL INSPECTIONS (952) 447-9850
..