HomeMy WebLinkAboutBuilding Permit 04-198
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
/SJ 0 0
Date Rec' d
:J. Z~ ~ df-
I. White File I PERMIT NO I
i' ~~~I:w ~::Iicant · 0 '/." 0 19 ~
ZONING (office use)
If!,Ar a
PISH ,oDIN T /Z<J.
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION rlRVe::r /Jr
PID "Z--5: ()39. /)Z,z,. 0
OWNE~ k-
(N ame) rO\. V'\
(Address)
3~C)
D-'
, ,ver
(Phone)
L(41 - S I 'f.3
F~
TYPE OF WORK 0 New Construction ODeck
OAddition o Alteration 0
BUILDER c.. CD" ~"f.
(Company Name) . "'-5o.....(\..OVc-. - ~
(Contact Name) :::tO~ R- L.o,.s C1.1"<>-e.........
(Address) 3t>l bf~ lJe\ k-b 1/(.
CODE: 'tia1.R.C. DI.B.C.
Type of &nstruction: I
Occupancy Group: A B E
Division:
(Phone) (;:;>1 J-"" 1'I..f 0 - 1/ oca
(Phone)
Porch ORe-Roofing ORe-Siding
ill Connection 0 Misc.
o Fireplace
II III IV~ A &3
F H I ~(1t>su
1 2 4 5
OLower Level Finish
PROJECT COST IV ALUE $
(excluding land)
x
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 r voke t . per . for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed lOspections.
4aS-l 3~x:'-ot.f
Signature
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When Approved
~~
Building Otlicial
3/z.9/0 :3
Date
Contractor's License No.
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer /W ater Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE ~ .2, ~(J. 04- $ 2- t.{ ,. ...., "
Paid
Date
Z4{,~ +(,4-
~. .0
I ~;ce~ +u,3 I
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.
0'OV.~
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
" > ;r~:,;>~~:;~':';_{?l,',~, ;'Jf~t'~~::':':;:+\:'('ltil '
The Building, Engineering, and Planning Departments have reviewed the buUdingpermit
application for construc~.o~,a;d;hic~.s~r:~~7d at;:'c_Jf /2 d-
/ . . L----r,<.;. & _
Accepted
y
Accepted With Corrections
Denied
Reviewed BY:~
Comments:
Date: 6 "oUt 0+
liThe issuance or granting of a permit or approval of plans, specifications and
computations shaH not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the Jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid. II
The Center of the Lib Country
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT ~ ~~~
APPLICATION RECEIVED .3 - :x b- tyj
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is prop~ed atff vJ ,
/3~ -q;/4!u f~
Accepted
Accepted With Corrections ~
Denied
~ Ur-J Date: cj~~~
E~ aLII
Reviewed By:
Comments:
liThe issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
PRIOR LAKE
.
INSPECTION · RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ,
NATURE OF WORK
. USE OF BUILDING
PERMIT NO. 04. 0/'18 DATE ISSUED ,-9
CONTRACTOR u..S~~T' PHONE~rz. ,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
.
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet Is available, card shall be placed near main entrance.
\
FOR ALL INSPECTIONS (952) 447-9850
~ tillE
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED. ~ ~ tJ 4-
L5~f7&#H~
. .. r
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
4- /r&
o FOOTING 0 PLUMBING RI 0 EXIGRADIFILLlNG
C FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
C INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
~INAL ~ 0 PLUMBING FINAL 0 GASLlNE AIR TST
o SITE INSPECTION 0 MECH FINAL 0
COMMENTS: C C-CJ <6- h c..B-
,
~RK SATISFACTORY. PROCEED
o CORRECT ACTION A D PROCEED
o CORRECT ~LL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYI
INSNOTl