HomeMy WebLinkAboutBuilding 04-1156
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please
ADDRESS
/1R7Z8
w/tI.os~1C-
Date Rec' d
II. /2..()4-
White
Pink
Yellow
I PERMIT NO. 04-. / / S70 I
File
City
Applicant
LN.
ZONING (office use)
/eI..rt)
LEGAL DESCRIPTION (office use only)
LOT4-BLOCK":? ADDITION tvlL-P. ~(),vOf Z,J)
PID zS. 3,) r. 0 V-, D
OWNER /7 .-- " ....r~ '
(Name) ,taJSCld/" (l //tI/-<#~I///I'II4--2
(Address)
(Phone) ~-S~";)-~C//) '-C)/h_?
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding
OAddition DAlteration DUtility Connection 0 Misc.
CODE: ~I.R.C. DI.B.c.
Type of &nstruction:
Occupancy Group: A B
Division:
I
E
II
F
1
III IV V A
HIM R
2 3 4 5
Lower Level Finish 0 Fireplace
IV{.
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby certify that I have furnished mformatlOn 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
above-mentlOned property and that all construction will conform to all eXISting state and local laws and will proceed in accordance with submllled plans. I am aware that the building
official ~hIS permIt for Just caus/,:Fu' neI~ore, I hereby agree that the CIty official or a designee may enter upon the propelty to perform needed inspectIons.
X .~ iLL ,- 1/-/2~O~
Signature Contractor's License No. Date
Permit Valuation J, 0 0 O. 0 0
Permit Fee $ 31-. 75
Plan Check Fee $ -
State Surcharge $ 6D
.
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When Approved
~omr.J~ II/r,::/P'/
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other ~c::r. $ j",(JfJ
TOTAL DUE $ 3&.25"
f/'NO
-f'f':J7
Paid
Date
3~.26
II. Z-~d f-
ThIS IS 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 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 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
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS /fp7Z?"" WINOS(J~ uJ.
NATURE OF WORK ~W~ l-6I/C:'- - / .ePl.
USE OF BUILDING J /JjjYL
PERMIT NO. 0 <t- < / /50 - DATE ISSUED / /. ( Z. 0 <f...-.
CONTRACTOR UIA.l/C#'"ft/'1,'V/~ PHONE #7. tJ /(,3
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
OUGH - INS
INSPECTOR
DATE
FRAMING
INSULATION
ELECTRICAL
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
r )..--Dt
HEATING I-vOl
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