HomeMy WebLinkAboutBuilding Permit 04-0036
(Please type or print and sign at bottom)
ADDRESS
CITY OF PRIOR LAI(E BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I, White File
2, Pink City
3, Yellow Applicant
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fr In IJ / e wu cd.
LEGAL DESCRIPTION (office use only)
LOT X" BLOCK / ADDITION --Jt(),.-IAtrudlfl~ ?~
OWNER
(N ame)
:r~,{-+
(Address)
BUILDER -r"f"'" $
(Name) J ~
(Contact Name)
(Address)
3". () k,...... S CI\-,
(Phone)
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SPlA1 ~ uf ,q.L~
(Phone) -'.?)j - y~ ~ - i Iei'()
(Phone)
TYPE OF WORK
o New Construction
~Lower Level Finish
f3t~Se-ll1etJ t
o Misc.
ODeck
o Porch
ORe-Roofing
Date Rec' d
PERMITNO.~L/_ (/LJ3~
ZONING (office use)
f:/
PID;J5- 3'f()- OOf-()
" I j - C) ~I.. "f J9
Gel.
o Fireplace
OAddition
ORe-Siding
OUtility Connection
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-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted pia . I aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upo e erform needed inspections.
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
Signature
o Alteration
PROJECT COST/VALUE (excluding land) $
(Y..(' ')0 8'( e; ~
Contractor's License No.
$
$
$
$
$
$
$
$
/000, DO
~S'
ISD
Park Support Fee
SAC
'N"ater Meter Size 5/8"; I";
Pressure Reducer
1;11-/ ~ ~
D~ -
City SAC and WAC
'N"ater Tower Fee
Builder's Deposit
Other
I TOTAL DUE
I Paid JP 35.~
I Date (-ifl-O L4
This Application Becomes Your Building Permit When Approved
-
~~
Building Official
J/).t/~V
Date
# $
# $
$
$
# $
# $
$
$
$ ~C)~ ifS
. :(./A .nJlr
Receipt No. L{':J ~ I r
_ By /'./
r
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
issued.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS 5 'I ~ If. khl b Ie u..x;oJ
NATURE OF WORK LJ- e::iI;O~1II-
USE OF BUILDING SF I .
PERMIT NO. ~- OD8'- DATE .wSUED ,- t? ,- ocJ
CONTRACTOR ,~1'~ ~J-~i ~ f..:6.rp PHONE-'~/- t../t, ~.~~
NOTE: THIS IS NOT A PERMIT FOR ANY OF tHE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
FRAMING
INSULATION
ELECTRICAL
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
1& -1 1~/
I
J
/
/
1/>
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
FINALS
fO
-z.. I] . v+--
,.
ATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NorlCE
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 adCfitions
where no service c~binet is available, card shan be placed near main entrance. -
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ~ '2 L
<../~ .
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
~INSULA TION to
4.FINAL Low.... L..~
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDUL.ED ~ ... " "S -0"(
A~\ ~ \~ '\)\-'
CONTR.
PERMIT NO.
4 - 031.0
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
I
/'/ /) /J
( 1 (JJjfK yt/
~ J\J C-/ I
'--/
~
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORR~RK, CALL FOR REINSPECTION 13EFORE COVERING
Inspector A) Owner/Contr:
cA~i At-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PEJ'lSONAL HEALTH & SAFETY!
INSNOTl