HomeMy WebLinkAboutBuilding Permit 04-0592
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and silitll at bottom)
ADDRESS
Date Rec'd
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Pink
Yellow
I PERMIT NO. OLf_1q~
File
City
Applicant
535"1
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ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT I BLOCK 3 ADDITION
~~~
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OWNER j,'"J.1' . j
(Name) --Li..'f ()J.A...I.~
'1 JJ, 1~
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
Y'j~ - r/~7 - ~tJ J'(J
(Phone)
(Phone'.
TYPE OF WORK 0 New Construction DOeck DPorch ~Roofing ORe-Siding DLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection D Misc.
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
mlVVA
HIM R
2 3 4 5
B
S U
PROJECT COST/VALUE $
(excluding land)
I hereby certifY that I have filrnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
above. mentIOned property and that all construcrion will conform to all existing state and local laws and will proceed in accordance with ~ubmittcd plans. I am aware that the building
offiCial can revoke thIS pelmlt for Just cause Furthermore, I hereby agree that the City offiCIal or a deSignee may enter upon the property to perform needed mspcctlOns
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Slgnaturl' - ( Contractor's LIcense No Date
I
Permit Valuation ;::;)-7-0:7___ I
Permit Fee $ /L/r/~ I
Plan Check Fee $ I-.d--~I
State Surcharge $ I
Penalty $ I
Plumbing Permit Fee $ I
Mechanical Permit Fee $ I
Sewer & Water Permit Fee $ I
Gas Fireplace Permit Fee $ I
This Application Becomes Your Building Pennit When Approved
Building Ufticial
Date
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
,
')~ _00
ReceiptNo YtbK<1 ~
Bv d--- I
Paid
Date
-/(0
I" - /z:;- LI
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 Ciry Planner constitutes a temporary Ccnificate 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
DATE TIME
SCHEDULED ~~~
clJ{-oo~ 0;-
ADDRESS
SJS?
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
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LL
(/ He
CONTR.
PERMIT NO.
CJ e;/ -<S'7 -2.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADfFlLLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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