HomeMy WebLinkAboutBuilding Permit 04-0089
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICA I E OF ZONING COMPLIANCE
".;....- .
- AND UTILITY CONNECTION PERMIT
Date Rec' d
1. White File PERMIT NO .
2. Pink City · 0' 11 -O~O'CI
3. Yellow Applicant 7 '"'0 I
(please type or print and sign at bottom)
. ADDRESS ./ __1
t;z.;5> 0 rOo h s
C/r c Ie-
r:;E
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
&-':.:R 111 ; If -e 9 M a. '1 'i I.~ G::, I h () f./ I? (phone)
(Address) S~?S /3,..,d() ks -(!;'rc/-e f,t::
~~~~R ~ 4e 1" f RJ (/. V r" 0 c-u "
(Contact Name) ""0 be r j- i~ 1/ Y" ("t?~ S'
(Address) q~ 96 l11a I;' _\1-
. ZONING (office use)
(Phone)
ftC/,;'q (Phone) 9c.-'}- ~6/
c-J~ MA/ S~O'UJ
I
TYPE OF WORK
o New Construction
o Deck
OPorch
ORe-Roofing
OLower Level Finish
o Misc. I--e..c., ~
o Fireplace
OAddition
DAlteration
PROJECT COST IV ALUE (excluding land) $
3bOh
~e-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 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
enterupo~r~rtyt~rfo~ededinsPections. _.. /'...... L C j-. _:>-OU
X 1\ tJ{J.JA, I ./~ 7 fJec,o / ry 011 ??? 7
Signature Contractor's LIcense No. Date
I Permit Valuation Z t;Oo, DC
Permit Fee $ 7"1. 75
Plan Check Fee $
State Surcharge $ '.LS
Penalty $
Plumbing P~uuit Fee $
Mechanical Permit Fee $
Sewer & Water P~uuit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; I";
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
. Paid f 7~ .tJ7J
Date ~/~:J!O""
$
$
$
$
$
$
$
$
$ ~7" -~O
This Application Becomes Your Building Permit When Approved
~; . ~ ~/d-3 /tJ,-!
Building Official -J:Z:f C Date
Receipt No. q" ZSlJ
B ~~....... ----..... 1!1
. Y ~~A
,
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEqULED
ADDRESS
S J-~J g.~ C(~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
!Le - s;-~
COMMENTS:
i'"
~
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( / / I1S~
~ L/{ (/ '-
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"---
DATE nue
t::- /I-t:ftf
'-'-~
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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? WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W?!L' OR REINSPECTION BEFORE COVERING
Inspector: . Owner/Contr:
CAL:L 447-98 0 FOR THE NEXT INSP~CT10N 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl