HomeMy WebLinkAboutBuilding Permit 09-0795
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Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom)
ADDRESS
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 4 - 71) I
ZONING (office use)
/6350 ~'Lh~;~
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
(Address)
/6330
BUll..DER
(Company Name)
(Contact Name)
(Address)
Dwfte.. '"
C Lt.... ve-
Sf
PID
(Phone)
., !")~ ~~f) - 8' 77 ~
{ .....I'"~
rE
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding J:(Lower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection
CODE: "RR.C. DI.B.c. o Misc.
Type of 0 tmction: I II III IV V A B PROJECT COST/VALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have furnished information 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-menl1oned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submittcd plans. I am aware that the building
official can revo this erm or just caus urthermore, I hereby agree that the City official or a designee may enter upon the property to perform necded lllspeC110ns.
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
/p-~-o'
Contractor's License No. Date
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 $ I eq :2G
Paid ~~(~ ~ Receipt No. ,t1~~
, Date By
'"
2..-
0.-
SO.'-
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 requestcd. This document
when signed by the City P nner constltutcs ~ temporary Certificate of Zoning mp .ance and allows construction to commence. Before occupancy, a Ccrtificatc of Occupancy must be
issued if) 0
Da Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUilDING AND INSPECTION
SITE ADDRESS {~~3D ~IC"\Z)""'lA-CA.J~\J&
NATURE OF WORK ~a-. Lev6<=- HNISW
USE OF BUILDING ~ A/IL ,
PERMIT NO. ~ -, et 5 DATE ISSUED te;/z Ioct.
CONTRACTOR M.(C;.fAEt. &1'Z.ue?BCL6" PHONE 440 ~ A ll2-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I-
I
I
~ (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
I
,
I
f
~
TIC
~
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if req~ired)
FIREPLACE ii
GAS LINE AIR TEST ? e3
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
II
---
__..,JIHmn1~
BUILDING
ELECTRICAL
PLUMBING
HEATING
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