HomeMy WebLinkAboutBuilding Permit 04-0928
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
9. /5. ()4-
I White
Pink
Yellow
I PERMIT NO. ()#-. orz~1
File
City
Applicant
(Please tvue or urint and sil!:n at bottom)
ADDRESS
57 9 7 M/UJ/ AI /17--- R:...f 0 ~ ~
ZONING (office use)
Puo
LEGAL DESCRIPTION (office use only)
LOT z.. BLOCK '2-. ADDITION ~/1J /rL.-- {2..IcPtP-G /d'T
PID z.5. Z~f, 6 z z.. 0
OWNER
(Name) f'l\tx -t\- ht.j.V W.c..1 ('~c\\-(.,\
(Address) S;-'7 ~ 7- C.......,:-)~-....\.
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone) Cf,S- d.. '-1"1 a - 1,1/</
~ (/SZ-. ZS9. 7~S(,
(Phone)
(Phone)
TYPE OF WORK 0 New Construction
DAddition DAlterat on
CODE: M":.R.C. OLB.C.
Type of t:~tmction: I II III
Occupancy Group: A B E F H
Division: I 2
eck [lfPorch ORe-Roofing
DUtility Connection 0 Misc.
IV V A
I M R
3 4 5
B
S U
ORe-Siding OLower Level Finish 0 Fireplace
~ 'I. .z::..
PROJECT COST IV ALUE $ I 000
(excluding land)
I hereby certit'; that I have h.lrnished Information on this application which is to the best of my knowledge true and correct I also certlt'; that I am the owner or authOrIzed agent for the
I above-mentIOned property 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 building
I otficlal can revoke thIS pelmlt for Just cause Fmthermore, I heleby agree that the CIty offiCIal or a deSIgnee may enter upon the plOpelty to perform needed Inspectmns
X ~l,~/h---~'----- 7- /3- 0'1
SIgnature Contractor's Ltcense No Date
Permit Valuation ~S-t:?t7t7. -0
Permit Fee $ //?: 7-5'-
Plan Check Fee $ 7t,,'ry
State Surcharge $ -2, S-t'
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
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"8 '[d' 0 ,- ' I
1I1 IIH! ttlClil
9/u~r
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOrAL DUE ~ q. 21. 04- $ /9~ ??' V
~
',-
ThIS IS to certit'; that the request In the above application and accompanying documents is In 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
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
/
~
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS 57CJ7 ernz.o/N'A-L /Z40G6 ~.
.
TYPE OF WORK 06Vc ~ PorZ4l-f
USE OF BUILDING j2ES /l-//L-
,
PERMIT NO. 0 ~ ~O 9Z-B DATE ISSUED 0/. /(P.O 9-
BUILDER W6/NcE.TT& L- PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~R DA"'/
I FOOTING I I f/As /(j~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
. I FRAMING I I
. I FINAL I I
FOR ALL INSPECTIONS (952) 447-9850
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