HomeMy WebLinkAboutBuilding Permit 04-0007
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(Please ~e or print and sign at bottom)
ADDRESS
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White
2. Pink
). Yellow
File
City
Applicant
I PERMIT NO. 04-. ()or71
.
60LfCV'1 T
772A'1'L-
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
PID 25'. :3 62-. 0+8 (.,
OWNER _
(Name) Ir" ,,; '"
(Address)
1/ L. 0
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
mark"
(Phone)
Date Rec' d
/. (p. 0 1-
ZONING (office use)
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ORe-Siding
DUtility Connection
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 revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon the property to perform needed inspections.
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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
8"b".,-i
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Ir/ 'I
(Phone)
(Phone)
o New Construction
~ower Level Finish
DDeck
DPorch
DAddition
DAlteration
ORe-Roofing
o Fireplace
PROJECT COST IV ALUE (excluding land) S
Signature
Contractor's License No.
$
$
$
$
$
$
$
$
4:-; IIVO J}[)
g7 2rr;;"
Park Support Fee #
SAC #
-
Water Meter Size 5/8"; 1";
1 Pressure Reducer
I City SAC and WAC #
I Water Tower Fee #
I Builder's Deposit
I Other 6U? e.7iv1 tUn--
I TOTAL DUE
2.0D
40 . Cf7)
This Application Becomes Your Building Permit When Approved
Paid
Date
/3 0. z...r
c/.t,,04-
Building Official
Date
/ / G. /0</
Date
$
$
$
$
$
$
$
$ /. 00
$ /3D. 2-S-
Receipt~o.
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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 ,.....l'v.......] 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
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 3/ to () tJ o.fl t!.AT 7/ZA-1 L-
NATURE OF WORK L-OvvElZ. LEvE:~
USE OF BUILDING /?~ S .4/e-
PERMIT NO. 04-.066 bATE ISSUED /. G.. 0 1-
CONTRACTOR /"ll"7leTIN PHONE Z-7-(g. G. S 07
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
I'f
I
~
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
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HAS
/-1 Z,
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
OCCUPY UNTIL ABOVE
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.
BEEN SIGNED
FOR ALL INSPECTIONS (952) 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
7-1'-
ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
L{ -06(
o FOOTING
o FDUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RJ
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RJ
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
Inspector.
Owner/Contr:
CAL. 850 OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
,,/' /
-C-ODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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