HomeMy WebLinkAboutBuilding Permit 04-0605
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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White
Pink
Yellow
File
City
Applicant
I PERMIT NO.O 1-- Olp os1
(Please tvDe or print and si~ at bottom)
ADDRESS
1'lL/Oo- Oeef- -fIeld
D\-.
~.P
ZONING (office use)
IC?Z-.
LEGAL DESCRIPTION (office use only)
LOT/tRBLOCK.3 ADDITION ~t&z.L)
9w
PID 2.5: +00. 0.57. 0
OWNER L1 . . .J.
(Name) ------,lI-L! ~J.I c. /
(Address) I '1 L/ II i'l - [) e e h
If. ..J .tf1u ~ I e L1Lj~alJ.bh
~I eld bh 5,[:'
(Phone)
q!i:J -I./'I/] - if {., ::>, 3
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
e:XIS77 /\/61 RJp77tV~ J
TYPE OF WORK 0 New Construction 'Wneck DPorch DRe.R~ofing DRe+Siding I DLower Level Finish 0 Fireplace
DAddirion DAlterat(;;; DUtihty ConnectIOn 0 Misc.
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
r
E
II
F
t
mrVVA
H r M R
2 3 4 5
B
S U
PROJECTCOST/VALUE S
(excludiug tand)
I hereby certify that I have furnished mformation on this application which is to the best of my knowledge true and correct I also certify that I am the owner or authonzcd agent for the
above-mentIOned property and that all construction will conform to aU existing state and local laws and will proceed in accordance with submitted plans I am aware that the building
:",',1 ,n evoko th.s p"m" Ot"lJ,'" 'rth"mo", I h",by 'gm 'hot 'h, "ty off,,',1 m, "",gn" m,y co,,, opon ,h, pmpmy to p,,'mm n'Z,d m::""'78 _ LJ . .
('. SignaMe Conteactor's License No. Date 1(
Permit Valuation J .300.00 Park Support Fee # $
Permit Fee $ 5/.00 SAC # $
Plan Check Fee $ 33. 15 Water Meter Size 5/8"; 1 "; $
State Surcharge $ (,-S Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Permit Fee $ Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
Gas Fireplace Permit Fee $ TOTAL DUE $ f3 -1-. fj 0
.
This Application Becomes Your Building Pennit When Approved Paid 'f:)'1-,f:')O Receito. 'r7.xJfiJ
~. ~ &/;F/ot{ Date ". /IL04- By _.
0
Building Otlicial f Date
ThIS is to certify that the request in the above applicanon and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requcstcd This document
when signed by the City Planner COnStllUtes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issucd
Planning Director
Date
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any
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PRIOR LAKE DEPARTMENT OF
BUilDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS / '7 ~O 0 06b /2/1 t/--W O/L,
TYPE OF WORK O~
USE OF BUILDING IZ6S /IlK-
PERMIT NO. 04-.6 (0 os- DATE ISSUED {p. /6.04-
BUILDER PRUt....SO AJ PHONE # 44'1 '1-1.','
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
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INSPECTOR
OATE
I FINAL
I /lIl~
7-(r.-(/U
FOR ALL INSPECTIONS (952) 447-9850
7'(,'
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
7 -/~-trCf
ADDRESS
17U(J()
~,.fkl d
OWNER
CONTR.
PHONE NO.
PERMIT NO.
L(-Cos-
o FOOTING
o FOUNDATION
o FRAMING
~~~~TION tJecl(
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
----------
------ ~
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"----- -----
11 WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~J1#OR REINSPECTION BEFORE COVERING
Inspector: --JI--!!l Owner/Contr.
gALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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