HomeMy WebLinkAboutBuilding Permit 11.0048;12.262 !v
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O* PII CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 5z-/-12_
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AND UTILITY CONNECTION PERMIT
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M jNNESo 4t' I. white i
City PERMIT NO. /2 2 4
2. Pink C
3 Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS — J � / � �� /n � C 4 ZONING (office use)
7 i
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION PID •
(Name) DA 4) i e / cSk kyL' cS /< (Phone) 1 , C) ; 8 7
(Address) / 9 7 7 / , / kI m's," Le.) c.J 4 it— N iv
BUILDER
(Company Name) (Phone)
(Contact Name) (Phone)
(Address)
TYPE OF WORK ❑ New Construction ❑Deck ❑Porch DRe-Roofing ❑Re- Siding L ower Level Finish ❑ Fireplace
DAddition ❑Alteration DUtility Connection
CODE: ❑I.R.C. ❑I.B.C. ❑ Misc.
Type of Construction: I II 1I IV V AB PROJECT COST /VALUE $
Occupancy Group: A B E F HI MR S U (excluding land)
Division: 1 2 3 4 5
I hereb certify that I have furnished information on this application which is to the best of my knowledge true and correct. 1 also certify that 1 am the owner or authorized agent for the
above- ntioned 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
official revoke Ts for just c . Furthermore, I her ` y agree that the city official or a designee may enter upon the property to perform needed inspections.
Signature 1‘..\.. Contractor License No. Date
Permit Valuation ar U73D • 0 0 Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fee $ Water Meter Size 5/8 "; 1 "; $
State Surcharge $ Pressure Reducer $
Penalty $ Sewer /Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ /�� 25
•
This Applicati ecomes Your Building Permit Whe Approved Paid & � 2.-5 R / vim pt No. t e ��
p q 12---- ' Date 5. Z/ /Z.-- c �Y
B mg Official Date
This is to certify hat 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
issued.
Planning Director Date Special Conditions, if any
24 hour notice for all inspections (952) 447 -9850, fax (952) 447 -4245
4646 Dakota Street Prior Lake, MN 55372
DEPARTMENT OF
P RIOR LAKE BUILDING AND INSPECTION
INSPECTION RECORD
1
SITE ADDRESS ¢7 7 7 8 7 t- '✓U
NATURE OF WORK (2) c = ,e , S
USE OF BUILDING re--6 /9f/Z --
PERMIT NO. /Z • 4 2- DATE ISSUED 2- 7- (2_,
CONTRACTOR S 130S PHONE 5/3 , Eo1
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
411111.11111 1
1 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMI
INSUL ATI O N
ELECTRICAL
HEATING (if required)
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1
FINALS
BUILDING
ELECTRICAL
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
PRIOR LAKE BUILDING AND INSPECTION
1NSPECTION RECORD
SITE ADDRESS / 1-7 7 / 77 /? eCfe_,W oc 1>� 7X-
NATURE OF WORK L(WOL- /✓El/L2 ' re -ervt i
USE OF BUILDING &e7
PERMIT NO. /t 41 DATE ISSUED /, z 1 /
CONTRACTOR S /IFe (J -jK-( PHONE 7 3 . f'o 7
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BLOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
1 1 1
l 1 1
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING F N& # i 7, % -
INSULATION
ELECTRICAL
MOM
HEATING (if required) L)c_
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
1 1
FINALS
BUILDING '/ (/
ELECTRICAL
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