HomeMy WebLinkAboutBuilding 04-0950
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
9. /5. 01-
White
Pink
Yellow
File
City
Applicant
PERMIT NO. 0 1'. 095'0
(Please
ADDRESS
at bottom)
ZONING (office use)
~/
'SS7
8q.ssWi!)'~cl
C; If' .:/e
.s lU
LEGAL DESCRIPTION (office use only)
000 W:J-.
LOT BLOCK ADDITION '-lId Il2w..s
'~$/'.J
)~
I.J d, f,~,,;
PID ;l
OWNER
(Name) R Ov,
&vo~ch ~ /
(Phone)
(Address) 355-7
C,'v, (e
50
BUILDER
(Company Name)
(Contact Name)
(Address)
SRif
.s e If
(Phone) 9:TJ.-'1ifO -39/3
(Phone)
TYPE OF WORK 0 New Construction rg"Deck )glPorch ORe-Roofmg
OAddition OAlteration OUtihty ConnectlOn 0 Misc.
CODE: K.R.C. DI.B.c.
Type of ~~stmction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
ORe-Siding OLower Level Finish 0 Fireplace
PROJECT COST IV ALUE $ ~ 000 --
(excluding land)
I hereby certify that I have furnished mformation on this application which IS to the best of my knowledge true and correct. I also cnut)< that I am the owner or authOrIzed agent for the
above-mentiOned property and that all construction will conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
offiCial ~oke thIS pelm;t for Just cause ~tl1thclmore, I hereby agree that the City offiCIal or a designee may enter upon the propeny to pel form needed mspectlons
X ~'- (9UJ#:~'{ 9 - /~- - 0 if
SIgnature Contractor's LIcense No Date
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
Park Support Fee
SAC
Builder's Deposit
Other
#
#
Permit Valuation
Permit Fee
Plan Check Fee
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
#
#
TOTAL DUE
(~
Building Otliclal
7d/~/
r Date'
I P'id~" ~
Date' . ~ - JLI
I
This Application Becomes Your Building Permit When Approved
ThIS IS to certIfy 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 Cet1ifieate of Zoning compliance and allows construction to commence Before occupancy, a Certlficate 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
.,j
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS 3557 BASSwooD (!./lee,LE
TYPE OF WORK DSCK.. ~ poeeH
USE OF BUILDING /Z6S 11/ ~
PERMIT NO. 04-. 0750 ' DATE ISSUED q Z/.o4- . ..
BUILDER (/Je OS (' r/6 L.. PHONE # 440...3V 1'6
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT I BY SEPA TE DOCUMENT
. j/ r'. r1 ,....-
,,/V't /', 011/ 'Os
FOOTING '? 2J. t.:/'
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SI/G~ED
I FRAMING I 1"}1/j- I S/'/I!o~
I
I
I FINAL
J/VI,/l I Lt r (0/ 02{
,
FOR ALL INSPECTIONS (952) 447-9850