HomeMy WebLinkAboutBuilding Permit 04-0422
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
5. 1f.'4-
I. White
2. Pink
3 Yellow
File
City
Applicant
I PERMITNO'O~.o4-Zz..1
(Pl.... !YJI< or print and sixn at bottom)
ADDRESS
ZONING (office use)
leI s.D
1(P510
/NqUA-OO/J/I
06/1 eH CJ Ie...
LEGAL DESCRIPTION (office use only)
PID 2.5_ a?5". 0/3.0
LOT
ADDITION
BLOCK
OWNER
(Name'
9r :f<.. - <I'f? -7...9 't 0
W,19 H t- I jt?,OGe.e..
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
W I"l H t-. /UJilGK..
f
(Phone)
(Phone)
TYPE OF WORK 0 New Construction rwoeck DPorch ORe-Roofing ORe.Siding DLower Level Finish 0 Fireplace
DAddition DAltera~- DUtility Connection 0 Misc.
CODE: Or.R.C. OLB.C.
Typ. of Construction:
Occupancy Group: A B
Division:
PROJECT COSTlV ALUE S
(excluding land)
I
E
II
F
I
ill IV V A
HIM R
2 3 4 5
B
S U
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
:dal caM'~'j~mo'e, I hmby .wee thot the dty official 0" designee m.y ent" upun the property 10 peo-fo,mnecdcd ;;=-J;s~ /0
- Signature" Contractor's License No. / Date I 'f
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
TI1) 'P-
Kg' ~s-
Sf '3J
5;0
I -
Park Support Fee
SAC
I Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTALDUE
$
$
$
$
$
$
$
$
S
#
#
$
$
$
$
$
$
$
$
#
#
1'-11 LL
I Paid
i Date
/~ '7./ /
-.ffi"- 11.#4-
I R~J.,~~~9/"1
Bv .
TW7/f17lE:_Yom Buildmg p.nm~:~::~V'd
Builliing Otlicial 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
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
'.
'4
~
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS j(P5/0 /N(iUrtO();J';r:f /ferret!
TYPE OF WORK Dee?-
USE OF BUILDING J;ZGS" /l#z-
PERMIT NO. 1J4-. o4z-z-' DATE ISSUED 5./1. otl-'
BUILDER W/J#{""" PHONE # 4-4-7. zB90
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
J
J
j
.
'FOOTING tlfllV~ b~/.rr/l'../~ I I
'PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
'",I.M8Dtfi I I
I FINAL
/tT
FOR ALL INSPECTIONS (952) 447-9850
5',/0.0'1-'
'"
Page 1 of!
This drawing is neither a legally recorded map nor a
survey and is not intended to be used as one. This
drawing Is a compilation of records, Information, and
data located in various city, county, and stat. offices,
and other sources affecting the area shown, and is to be
used for reference purposes only. Scott County is not
responsible for any inaccuracies herein contained. If
dlscrepeancies are found, please contact the Scott
County Surveyors Office.
~
.
~
May 10, 2004
file:IIC:\DOCUME-l \Lynda\LOCALS-l \Temp\triJDCEB.htm
5/10/2004
, '
CllY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
1(./;/0 )0/0,/1,)0"".
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
(1./)(
COMMENTS:
DATE ' . nile
L/ - F< otl
11..7'"" {h
o EXlGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
,I
([) (()W( I'" (//1) [,/, -fdr c-f".c!(
v O-('/"",,-{
( )) , hn-li/^""",, rJ( raIl fI<,. I1<<J.' f;y b__ ~t
/.,- <;, (1.-,/41 LI/I
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
I" CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~ Owner/Conlr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
IN6NOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
CllY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE nlll!
.:1>.11. (Ill-
ADDRESS
/(,5"/0 /r./($t/"10tJ/o.//I ifeJ9(!H
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
~SULATION
INAL pec,c...
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
Otf-.o+zz-
o EXlGRADlFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
.
/l~Y
~ I/}J " fL /--'"
V"' ,V I,/)/\J
11, W-
IV .b~ d
AOJ,-C'
( J \
(1----
-1T J
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR RElNSPECTION BEFORE COVERING
Inspector: r17~ Owner/Contr:
CALLG7-'SO FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
"""""
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!