HomeMy WebLinkAboutBuilding Permit 04-0254
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(Please type or print and sign at bottom)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICAtE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3 Yellow Applicant
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(I~ 5-1-
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
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OWNER
(Name)
/V\.~C~II{
(Address)
~ {v~o.skof~1'
BUILDER
(Company Name)
(Contact Name) T ~ (I!~
(Address) 11"3 13 (fe-fter~
A ~ \/\;Cst'
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(Phone)
Date Rec' d
PERMITNOoGJ';I4 Q-s7(
ZONING (office use)
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PIra<5'- 9tJ;t- rJ./}~-(~
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(Phone) 7 b 3 - 11 )b"4~oL{
(Phone) VI JI
MN ~53/b
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TYPE OF WORK 0 New Construction ODeck o Porch ~-e-ROOfing ORe-Siding
OAddition o Alteration OUtility Conne~~ 0 Misc.
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
IT
F
I
ill IV V A
HIM R
2 3 4 5
C~~P}.l'\
OLower Level Finish
o Fireplace
B
S U
PROJECT COST IV ALUE $
(excluding land)
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
;Cial can revf't~~t for jn cause. Fu hermore, [ hereby agree that the city official or ~J ;~~1n the property to perform needed y::'/i1 -0 /.I{
'CPt!7\- /aignature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
(;l5OC/ ;----
$ 7'-(, 7S
$ I ,. ~s
$
$
$
$
$
$
This Application Becomes Your Building Pennit When Approved
Building Otlicial
Date
Park Support Fee
SAC
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid
Date
'7~ --
4-/ L(-oi/
# $
# $
$
$
# $
# $
$
$
$ '{(;, . ---
Receipt ~o. '-f-I:p6f(Po-
By 8---:;,
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, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
DATE nME
CITY OF PRIOR LAKE
INSPECTION NonCE
SCHEDULED 4.:::2J-
ADDRESS ~~ Cak>> ~':)
OWNER CONTR.
PHONE NO.
PERMIT NO.
t{ - '2-'3"
o EXlGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
o FOOTING
o FOUNDATION
o FRAMING
o INSULA T'RN ,....
~INAL '~0t:J~
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
N~ A<<..er~
+~~
~RK SATISFACTORY, PROCEED
o CORREC ACTION AND PROCEED
o CORR C't K, CALL FOR REINSPECTION BEFORE COVERING
Inspector _ Owner/Contr:
CA 1-9850 ~ THE NEXT INSPECTION 24 HOURS IN ADVANCE.
~ENTSARE FOR YOUR PERSONAL HEAL71l & SAFETYI
INSNOTl