HomeMy WebLinkAboutBuilding 04-1066
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
lti /2. ()4-
at bottom)
ADDRESS
5fr.5o
h1//!.-LAuJ ,.j
511o~~ IR-.
White
Pink
Yellow
I PERMIT NO. 04.10 toto I
File
City
Applicant
ZONING (office use)
ie/5D
LEGAL DESCRIPTION (office use only)
2-('130 3/
LOT I BLOCK ADDITION H111t'A:../I/1'/N SIfti/i:C:S
PIDZ5". 031. 0/3.0
I OWNER
(Name)
(Address)
BUILDER
(Company Name)
(Phone)
tf
P/2iot- LA4'
A,vJ
(Phone) L, { 2- - (;U/ - 0 [,.7 cf
(Phone)
~>~1l.-
6LO~S .~L/
(Address)
Ke::rn+'~ ~~rz;~v...
K. E IrM fht-,\I III ~U f
Zf) 45D &brJ tf"
(Contact Name)
TYPE OF WORK 0 New Construction ~eck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection 0 Misc.
CODE: f.R.C. OI.B.C.
Type of onstmction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5
PROJECT COST /V ALUE $
(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 certify that I am the owner or authoflzed agent for the
above-mentiOned properry and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
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. Signature Contractor's License No. Date
Permit Valuation 4/t'tV. &.0
Permit Fee $ / 03. ~t:J
Plan Check Fee $ t:.~. 'IS"
State Surcharge $ ,2. 0>0
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
.#~,'----
8uildll1!! Ofticial
/op ?ft(
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE ~ /tJ. IfJ.c4- $ /7~ ~..s-
ThIS IS to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. ThiS 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
ISs11e~l, rn. r/1eow- \\, ~ (j-f " " .
Planning Director Dat Spec- C
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
'"
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
TYPE OF WORK
USE OF BUILDING ~
PERMIT N9. ~ ~SSUED
BUILDER~e"~ c., PHONE #V"z ~ "VV
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING I ~ I /CJ/.,2~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
~ I I
I FINAL I I
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850