HomeMy WebLinkAboutBuilding Permit 04-0291
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
(Please tvne or orint and SilUl at bottom)
5301
White
Pink
Yellow
File
C;ly
Applicant
I PERMIT NO. 04-. O~ I
ft:.-tIt!/A/rl~ q<::....
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
OWNER
(Name)
(Address)
ADDITION
Date Rec' d
4.lqJ~
ZONING (office use)
PID 25./1'7 (J 07. 0
(Phone)
BUILDER .n f / .
(Company Name)!7I< 8A'f()tt~~
(Contact Name) J2w). /W~/';;ht77
(Address) 'f;:-7.. '1 /'2.~ r'...I.~ K~
..,
TYPE OF WORK 0 New Construction DDeck DPorch ORe-Roofing M"Re-Siding
DAdditlon OAlteration DUtility ConnectIon 0 Mlsc. r-'
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Gronp: A B
Division:
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
I
E
$
$
$
$
$
$
$
$
(PhOne)~5Z:) t./t.;7~".<:9?
(Phone)
~J#
5"<;<:7{7
DLower Level Finish
II
F
I
PROJECT COST IV ALUE $
(excluding land)
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 authonzcd agent for the
abuve-mentlOned propel1y and that all construction wil onform to all existing state and local laws and will proceed in accordance with submitted plans_ I am aware that the building
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-- Signature'/ Contractor's License No. -, Date
l./
"2, SlJU . (It)
74. 7~
IIIIVVA
HIM R
2 3 4 5
B
S U
Park Support Fee
#
SAC
#
Water Meter
Size 5/8"; I";
,I... z...-1-
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
#
#
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Pennit When Approved
Paid
Date
'7{,.CJO
4-./ 'i. ,4-
/J
ReceipfNo.
By'/ I .
(J
Building Oftkial
D<Jlc
o Fireplace
$
$
$
$
$
$
$
$
$
'i(o.()O
-I-~('sO
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 Cel1ificate of Zoning compliance and allows construction to commence. Before occupancy, a CertIficate of Occupancy must be
issued
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
S:jO/
Lh:~sCJ-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
,MI SULATION 0 SEWER HOOKUP
INAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: /J I
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DATE TIME
~~
,
c;...-
oe;/-.,z-r /
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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,4"'WORK SATISFACTORY, PROCEED
/ &- ~ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL F REINSPECTION BEFORE COVERING
Inspeclor:
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
,
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!