HomeMy WebLinkAboutBuilding Permit 04-0300
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICAtE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sip at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER ()
(Name) ".aJ"G.Y .,
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(Address) /, ?~,
I. White File
2. Pink City
3 Yellow Applicant
Date Rec' d
PERMIT NO. (5)4... ~
ZONING (office use)
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PIDX-~7-()03 -0
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BUILDER ~
(Company Namet/17.,A./It!.~G,/1
(Contact Name) --0:. ~
(Address) t:(~, ~ 1r 'J. r-t:Jt'i
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(PhOne)&~) 5~o-~/o//
(Phone) ~,.
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TYPE OF WORK 0 New Construction ODeck OPorch ~e-Roofing ORe-Siding OLower Level Finish
I OAddition o Alteration OUtility Conn;cilitn- 0 Misc.
CODE: lilII.R.C. DI.B.C. PROJECT COST/VALUE $
Type of Construction: I II III IV V A B (excluding land)
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
o Fireplace
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I ht:reby 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 enter upon the property to perform needed Inspections.
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Signature Contractor's License No. Date
Permit Valuation 2 Sot), -
Permit Fee $ ,4 ' -r;
Plan Check Fee $
State Surcharge $ ! .. --z,--)
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
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I ~;. ~ nfti~l) mate
I Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
I~ ....
I Water Meter Size 5/8"; I";
Pressure Reducer
I Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
Paid
Date
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~ 77.0(t4
.
Receipt No. tf(ph'-)
By f2014-
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
TOTAL DUE
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 NonCE
ADDRESS JJ,1l{ ~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA~N h.--
IHAL (JI
~ITE I SPECTION
COMMENTS:
SCHEDULED
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CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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~~
DATE nilE
q - St:JO
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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:f:.....WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CO~WOR~ CALL FOR REINSPECTlON BEFORE COVERING
Inspecthr: ) 1 . Owner/Contr:
-C';LL~O FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CO}J REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl