HomeMy WebLinkAboutBuilding Permit 04-0223
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Ree' d
I. White
2. Pink
3. Yellow
File
City
Applicant
[PERMIT NO.c:? C; -;2;)..3 I
(Please'!vp~ or print and si2I1 at bottom)
ADDRESS
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1-1 ) ;'/ Ie; .0
L/J
ZONING (office use)
Jel
LEGAL DESCRIPTION (office use only)
LOT C; BLOCK Ljj,.DDITION u.ufbuxr- t ex:-
PID,2S'" ol /jf - O'5(} -b
OWNER _ .
(Name) ., ~"I\..,
~
Os <>
(Phone)
(Address)
BUILDER
(Name\ ~ ""..,uCL.,^ c..>,,~.J G f"c.
(Contact Name) I~c<-..,n," 'S=_~ACL_V<
,p .,...",
(Address) ~ 0 '0 E '-( f1v c ->'k"Y\C0 t7e <-
(Phone) '1-;,-,-
(Phone)
TYPE OF WORK
DPorch
DAddition
DAlteration
o New Construction
DDeck
ORe-Roofing
DLower Level Finish
o Fireplace
o Misc.
PROJECT COST IV ALUE (exduding tand) $
,-/03 '7100
~e-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
authonze~ent fa above.mentioned property and that all construction will conform to all existing state and loca11aws and will proceed in accordance with
SUbm71tted s a ware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter up e to erform needed inspections.
X 72 S I <-/ - (. - <J <)
Signature Contractor's License No. Date
I Permit Valuation ;;)50tJ.~ Park Support Fee #
I Permit Fee $ /'1.15' SAC #
I Plan Check Fee $ 1 Water Meter Size 5/8"; 1";
I State Surcharge $ ra5 I Pressure Reducer
I Penalty $ I City SAC and WAC #
I Plumbing Permit Fee $ I Water Tower Fee #
I Mechanical Permit Fee $ ! Builder's Deposit
\ Sewer & Water Permit Fee $ I Other
I Gas Fireplace Permit Fee $ I TOTAL DUE
.....
This Application Becomes Your Building Permit When Approved
'/tL?-
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I
Paid
Date
Building Official
Date
$
$
$
$
$
$
$
$
$ /"IIo.oV
~kl;' S~
ReceiPt No.
By r
"
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, tax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ~~~~r-"
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMtNG
o INSULATION
~INAL
o SITE INSPECTION
SCHEDULED
~y' TIME
LLJ.;//":- .?-
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
4 /
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COMMENTS:
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/TdC$4/",;"
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../-
G:,/.L;'~
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o.y- ,.2-23
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
LLJ
,
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
~t:
, ..
Inspector:
Owner/Contr:
CALL "1-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUlREMENTSARE FOR YOUR PERSONAL HEALTH & SAFETY!
. n__.________"______.._,___._"~___
INSNOTI