HomeMy WebLinkAboutBuilding Permit 04-0292
(Please type or print and sign at bottom)
ADDRESS
.5 r(p 0
CITY OF PRIOR LAKE BUILDING PERMIt,
TEMPORARY CERTIFICAtE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
4 ~ 11r o~ '
I. White
2. Pink
3 Yellow
File
City
Applicant
PERMIT NO. () ". ozl12-
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ZONING (office use)
a,,1 ~
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
PID ZS-; IllS". O:l 1-.. 0
OWNER
(N ame)
(Address)
(Phone)
BUILDER ,.., 1 I
(COmpanyName)-D!? ~f)~7
(Contact Name) ~cJl'lcl /Joc/J.A Ii
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(Address) qm It7rd S' /. .BJ.orW,- "-t
(Phone)(j;5~. 2S fJ 1
(Phone)~/2- 6r~ -??1J
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TYPE OF WORK 0 New Construction ODeck o Porch ~e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
o Addition o Alteration OUtility Conne~~ 0 Misc.
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
:.:.~.~~~~or ~Furthennore, I herehy -- mal me ci~ 0;;';:']; ma51$n property 10 perform needed 7..h ,$9'
Signature ~ Contractor's License Ntf. 'Date
V
~ 50 0 ~<:/O
7&./.1~
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
I Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
I
E
ITI IV V A
HIM R
2 3 4 S
PROJECT COST IV ALUE S
(excluding land)
IT
F
I
B
S U
Park Support Fee
$
$
$
$
$
$
$
$
$
/)
ReceiPtflo.
B(f~.
1(,.(} 0
I
+r, (, SO
#
$
$
$
$
$
$
$
$
SAC
#
Water Meter
Size 5/8"; I";
.-
I ').A
Pressure Reducer
Sewer /W ater Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
This Application Becomes Your Building Pennit When Approved
Paid
Date
7(,. 00
/I'~ /9, d ~
Building Otlicial
Date
ThlS 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
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE
;f/4Y
~/ #r, z.,~
c);
TIllE
SCHEDULED
ADDRESS
<S:)~
OWNER
CONTR.
PHONE NO.
~-r--~?~
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
~SULATION
IHAL '
o SITE INSPECTION
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
COMMENTS,~ ~
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AK SATISFACTORY, PROCEED
o CORRECT ACTION ANt) PROCEED
o CORRECT ~~ ~ FOR RElNSPECTlON BEFORE COVERING
Inspector.~ /C ~ c;;: OwnerlContr.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
L..~ I... J.
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