HomeMy WebLinkAboutBuilding Permit 04-0365
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICAtE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sip at bottom)
ADDRESS f)
2.~D Cthtrr ?d. S~'
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
OWNER
(N ame)
(Address)
ADDITION
I, White File
2. Pink City
3 Yellow Applicant
(Phone)
~~~~~ Name) W kSP1h;-; rJ::, (~~
(Contact Name) (\G\v~ .N)~,-~ -
(Address) 71lJS~. )7:;+6 S-b, UJOr ~
PERMIT NO. ()'I- 3~S--
ZONING (office use)
PID
(Phone) Q52. tjl/'1 ,~
(Phone) IlJll. Q&8. 3~C>
~
TYPE OF WORK 0 New Construction ODeck o Porch ORe-Roofing MRe-Siding OLower Level Finish 0 Fireplace
OAddition o Alteration OUtility Connection 0 Misc. ".
CODE: OJ.R.C. OJ.B.C.
Type of Construction:
Occupancy Group: A B
Division:
J
E
IT
F
1
HI IV V A
H J M R
2 3 4 5
B
S U
PROJECT COST IV ALUE S
(excluding land)
I hereby certi 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 authorlzcd agent for the
oned pro fly ~~ all on Iction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
vok, lh~ mm C s~ FUrthmn~by """ thot th, C>'Y official '" a d";,,.'" may mt" upoo the p<opmy to - n7~s,. CfI
Signa Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
I State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
;:;)soo~
$ -;tt 75
$ I'~~
$
$
$
$
$
$
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
r;~..---
t:;- /-/JU'
......., ,
# $
# $
$
$
# $
# $
$
$
$ ~G.~
Receipt No. il6iOj
By /1
U
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 requcsted. 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 nilE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ~/d-()t./
ADDRESS mo u"Jv leJ
OWNER CONTR.
PHONE NO. PERMIT NO. Li: ,,3GJ
o FOOTING
[J FOUNDA liON
o FRAMING
o INSULA liON
o FINAL
o SITE INSPECTION
COMMENTS:
u)
t:: v1j" h
~ rfJ01 cL
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~~
o EXIGRADIFILLlNG
[J COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
[J
1lJA il./J.;
-.I
Lu~
(
...L W f..., Ju.....,
I(J~ (.-I've!
t.e..r-.p
W/ V'lc'd~
~RK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
[J CORREC~ ;'~OR REINSPECTION BEFORE COVERING
Inspector: Y Y / Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETY!