HomeMy WebLinkAboutBuilding Permit 04-0200
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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2. Pink
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File
City
Applicant
(Please type or print and sign at bottom)
ADDRESS
LEGAL DESCRIPTION (office use only)
LOT e; BLOCK I ADDITION D f::; t:;/'VPI E'l"o
OWNER
(Name)
(Phone)
(Address)
BUILDER
(N ame)
(Contact Name)
(Address)
tJ e:H }./ ~ ~JtJ.J 77L- .
~OI3 Ol?- ~CJHkJ
(Phone)
(Phone)
TYPE OF WORK
~eck
o Fireplace
o Alteration
ORe-Roofing
o New Construction
o Porch
OAddition
o Lower Level Finish
o Misc.
PROJECT COST/VALUE (excluding land) $
Date Rec'd
3. -S/~04--
PERMIT NO. 04--. 0 z.. 0 0
ZONING (office use)
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z, l' L .J '2r t.f1.
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
submi~plans. I am 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 ...~.9! ..tbe-property:~o perfo eeded inspections.
ff//./~A4.f)j' Q.. S~Z05S-13+~ 3~?G,04
./ , 19na e Contractor's License No. Date
/
f~it Valuation
Permit Fee
~L/()tJ() ,{JO
IO?' . 00
~(p. lfs
L~OO
Park Support Fee
SAC
$
$
$
$
$
$
$
$
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Water Meter Size 5/8"; I";
Pressure Reducer
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace PCHuit Fee
~B~O~dmgP;5~~rovoo
Building Official / date
/7/.9r
:J.,}1.0~
Paid
Date
# $
# $
$
$
# $
# $
$
$
$ 17 ( . Cf S
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-
Recei# No. ef're (,IJ
By (/' i
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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
'fi
.....
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS 17Z/!,;, WI LIJ~&S:f tA.
TYPE OF WORK ~
USE OF BUILDING ~ ~I A-
PERMIT NO. fJ'I. 02DCI rlrEiSSUED ~,.04-
BUILDER B/51f~ PHONE #~. JSIIJO
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
- THE PERMIT IS BY SEPARATE DOCUMENT
.
INSPETOR ....., DATE
FOOTING r ;y' / ?('I&-Oq
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
FINAL
/I
l/VV/
4-L3-0~
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/JJJS M/Jt=';'J1~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION/) ,I
~INAL 1/ .{ u/(
o SITE INSPECTION
COMMENTS:
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE TIME
4-~l:.OY
c:..1'
q -A10
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:S::O:ECT yvpOR REINS:::::::'FORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI