HomeMy WebLinkAboutBuilding Permit 04-0042
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File I PERMIT NO
'PI" Ci<y 'A .6_ _ A..
3_ Yellow Applicant '" -r -r '-"'
(Please.!VJ>e or print and sian at bottom)
I ADDRESS
~Z(p 1I(//'7/"1I/V'qdl/LO
ZONING (office use)
Ie..!
7J!.I1 / L-
LEGAL DESCRIPTION (office use only)
LOTI! BLOCK.3 ADDITION /t::No!T HIt..A-- 311&0.
PID zS. 3~. oz.",. D
OWNER
(Namp)
::ksM /lIIeJ,'-"
l/Il::; l ~ I-I/l-W1.IV1I'".,hIrA -rau' (
15Z--Z.Z.~ -~/'J7
..
(phone)
(Address)
,
../
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BUILDER
(Namp)
(Contact Name)
(Address)
(Phone)
(Phone)
ORe-Roofing
OAlteration
ORe-Siding
ODeck
o Pireplace
OPorch
OAddition
o New Construction
~wer Level Finish
3~s
TYPE OF WORK
Dutility Connection
PROJECT COST IV ALUE (excluding land) $
o 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
submttted plan" 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
;ter upon th~n=;~~ n~ded inspections 1/ ~ ~ /0 '-I
Ir~ Stgnature Contractor's License No Date
II
I Permit Vall!ation
I Permit Fee
I Plan Check Pee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Pee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Pee
$
$
$
$
$
$
$
$
$
~.-I
'1~.1~
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other ~'CA A.1.~
I TOTAL DUE
#
#
$
$
$
$
$
$
$
$
-
I.s-<=>
#
#
~..
I. -
lS"-.2.';-
40....
I ReceiptN~. ~Z3,
Bv P-DK - -
I Paid '5-'. ''-~
I Date I !'z....~tr 0 f'
This Application Becomes Your Building Permit When Approved
~I"^ 1/?-t1/DY
~~
Building Official Date
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.
Date Special Conditions, if any
24 hour notice for all L. . ...:. ." (952) 447.9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
Planning Director
I ,
...-' .-
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 45Z,(o 1i(/I1I1It.JGB/~ 77U-
NATURE OF WORK /-fOWFJ2... f..eVt::.,L---
USE OF BUILDING I2er A-/ /0
PERMIT NO. 04-~(){)4-2- ',DATE ISSUED t. Zq 04-
CONTRACTOR /'-1F.:TJIAJ V77S0N PHONE.....z...~. 5/97
NOTE: THIS IS NOT A PERMit FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
OATE
..
-~ I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
.
~
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
II
FINALS
rrtJ'
;14"/
/if/
/1/(/
11;:-
/
I
/
I
,~
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
rf1A
I/) - (1)
JJ
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
u,~
ADDRESS _45~~Vl'lvniV\,C 6it"~
~
OWNER CONTR.
CITY OF PRIOR LAKE
INSPECTION NonCE
SCHEDULED
PHONE NO.
PERMIT NO.
IJ FOOTING
IJ FOUNDATION
IJ FRAMING
IJ INSULATI9N L
X FINAL L.... ,
IJ SITE INSPECTION
IJ PLUMBING RI
IJ MECH RI
IJ WATER HOOKUP
IJ SEWER HOOKUP
IJ PLUMBING FINAL
IJ MECH FINAL
COMMENTS:
DATE
TIlle
3: 1-1
-
It" .
L/.. tJtJ If?
IJ EXlGRADlFILUNG
IJ COMPLAINT
IJ FIREPLACE RI
IJ FIREPLACE FINAL
IJ GASUNE AIR TST
IJ
/'
~RK SATISFACTORY, PROCEED
IJ CORRECT TION AND PROCEED
IJ CORRE ALL FOR REINSPECTION BEFORE COVERING
Inspector. ,
OwnerlContr.
50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
-,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI