HomeMy WebLinkAboutBuilding Permit 04-0583
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
White File
Pink City
Yellow Applicant
PERMITNO.4_ ~.B~
(Please tyP.e or orint and sim at bottoml
ADDRESS
I Lf I 5 \ L2.R. Jew- {Ubi)d
C!..,
ZONING (office use)
N.P.
/l- ./
LEGAL DESCRIPTION (office use only) J I
LOT U BLOCK.3 ADDITION ~
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PID2tJ. ~/t/- (j;J..S-O
OWNER A d .t-... .
(Name) V\. r~ U--"r II '; \l\e..
ce.cl- U )l'fOd
(Phone)
'i~.;l-4-t.j.5- :J.5~
9e:?..f - j ~ 2..
(Address)
14\ S\
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-
AJI::_
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction pCiDeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
DAddition DAlteranon DUtility Connection D Misc.
CODE: IlI5r.R.c. or.B.C. PROJECT COST/VALUE S
Type of &murnon: I IT ill IV V A B (excluding land)
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
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 J am the owner or authorized agent fOf the
a ooed property and that all constmction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
~Clal;an ev e 15 pllRflJt ~ (:.;r~ hereby agree that the City offiCial or a designee may enter upon the property to perform needed mspectlOns
- - ~ SIgnature Contractor's License No Date
Permit Valuation /)~-- I Park Support Fee # $
Permit Fee $ -r~_7< I SAC # $
Plan Check Fee $ ~."U-I Water Meter Size 5/8"; 1 "; $
State Surcharge $ r. -- I Pressure Reducer $
Penalty $ l I Sewer/Water Connection Fee # $
Plumbing Permit Fee $ I Water Tower Fee # $
Mechanical Permit Fee $ I Builder's Deposit $
Sewer & Water Permit Fee $ I Other $
$ I TOTAL DUE $ I 2-2 .~,
Paid I.?-~'(; cj Receipt No.
Date fA - itl-q By C;
c;;r-.....
ThiS lS 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 sigm.>d by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence, Before occupancy, a Certiflcatc 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
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS 14' S" ( C€oM-v.-a&>() C "t. N .;c.
TYPE OF WORK 14- )("2...0 ~
USE OF BUILDING F-e-s 1'r-/12.. .
PERMIT NO. 4-.583 DATE ISSUED ~ / (4/04
BUILDER ~D{J..-<:.".J D,VINe PHONE # 4(,C;''Z.~4-e
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING I /IU I vii7o;
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
~ I I
I FINAL
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FOR ALL INSPECTIONS (952) 447-9850
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DATE TIME
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PERMIT NO. ~ <./ - S?J
,
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
~SULATION
FINAL
o SITE INSPECTION
o PLUMBING RI
[J MECH RI
[J WATER HOOKUP
[J SEWER HOOKUP
D PLUMBING FINAL
D MECH FINAL
COMMENTS: )
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D EX/GRADlFILLING
[J COMPLAINT
[J FIREPLACE RI
o FIREPLACE FINAL
D GAS LINE AIR TST
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C.J6S~ n-/~/
~WORK SATISFACTORY,
/;~ORRECT ACTION AND PROCEED
D CORRECT WORK~CALL FO REINSPECTION BEFORE COVERING
Inspector: Owner/Conlr:
,
CALL 447.9850 FOR THE NEXT INSPECTION 2. HOURS IN ADVANCE.
INSNtlfI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/