HomeMy WebLinkAboutBuilding Permit 04-0541
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please ~e or mint and sign. at bottom)
ADDRESS
YYo3 9o~~ \,).... E",~
--\ro-..-;-\
LEGAL DESCRIPTION (office use only)
LOT""Z.-:BLOCK ~ ADDITION fA..)'AN7S~~,N",
OWNER r . , \ ,() \ Ie V f-o
(Name) -----'V-' n..c e.... ~ \"\~....... '^. .~( 0.-
(Address)4~O:' ?;:)"J\.};-~W \:-"'0..,,\ S~
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o New Construction
DDeck
DPorch
~ :z..c::: -,(. Ie-'
DLower Level Finish
DAddition
PROJECT COST IV ALUE (excluding land) $
o Fireplace
$l-'c~
Date Rec' d
(p .4-.04--
; '::;:;:" ~:~y I PERMIT NO'OA_. 054-/
J. Yellow Applicant r
sE
Zfi.~Glfficeuse)
I
PID Z,-.. J 3'" -O(Z-C:;
9.5&- 4Cf') -'IaJ S-
.s:--S3)L
(Phone)
pc. m---
(Phone)
(Phone)
ORe-Roofing
DAlteration
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 a are that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
tf' ~on the prope 7m needed inspections.
e:.. - , Signature
Contractor's License No.
Date
I Permit Valuation I -z...SC\O. ~ I Park Support Fee # $
I Permit Fee I $ 14-~1') I SAC # $
I Plan Check Fee I $ i Water Meter SizeS/8"; 1"; $
I State Surcharge I $ 1.2.'; I Pressure Reducer $
I Penalty $ I City SAC and WAC # $
I Plumbing Permit Fee $ I Water Tower Fee # $
I Mechanical Permit Fee $ I Builder's Deposit $
I Sewer & Water Permit Fee $ I Other $
I Gas Fireplace pe"fit Fer $ I TOTAL DUE ~ &.1'.11""- $ C:". -
~ .- I ~~Ce~97f}
I Paid '7(,.00
I Date (,.+.,~
""-. 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.
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
SITE ADDRESS 4 4 0 3 ,?e>r0C>\1 t~ ~l.... S'. E.
, ,.
TYPE OF WORK lc.. lC. 2':; Ac<..eSS.,fZ..! ~-C>""
USE OF BUILDING R.e-~ ...../~
PERMIT NO. iJ 4.054-/ DATE ISSUED c.!~ /0 4
BUILDER vJAoQI$- K'1 r.",\...A. PHONE # +4" - 4"t..\ ~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR "DATp.
I FOOTING '1ell-,~... SeT&Aoc." \0 vJ&tLJ.- ~ I 1/ e/:t?t/
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I FRAMING #",.,r I A- I ~/ft/
. , FINAL ~1 Jf~.
, I
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
q70?
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
A:ESULATION
INAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED J;/y/ of
A~ dt,h ~ <../ ~/
CONTR.
PERMIT NO.
.cYe/- Sc,//
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~ORKSATI~t'''vw~':<
~ORRECT ACTION AND PROCEED
:s::o~ECT Wi' CALL F R REINS::::::::FORE COVERING
CALL M7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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