HomeMy WebLinkAboutBuilding Permit 04-0646
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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City
Applicant
I PERMITNO'Oij-h~{{
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ADDRESS
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LEGAL DESCRIPTION (office use only)
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LOTIO BLOCK
ADDITION
OWNER
(Name)
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EIIIhM\
(Phone)
(Address)
~~~~~Namp) n'VluLl Cm'l5trnd-/6-h LL'-
(Conract Name) ta.N\ f)' VLei.U
(Address) '601 q 4'1+\1\ Y\.l~ V\ Yl e,u) ~O:u.'
Date Rec' d
ZONING (ollk, u"j I
PID ,;J<)" - /h:3 - ()/() -0
(Phone) 7b3-J3J..-l:,3~'1
(Phone)~h3-~3J-- 103;}, 1
vn VI ~5Y;J-,?
TYPE OF WORK 0 New Construction DDeck DPorch [2R.e-Roofing ORe-Siding
DAdditton DAlteration DUtility Conne6~n 0 Misc.
DLower Level Finish
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
D Fireplace
B
S U
PROJECT COST IV ALUE S
(excluding land)
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1 hereby ccrtify thall have fiJrnished information on this application which is to the best of my knowledge true and correct I also certify that I am the owner or 3uthnnzed agent for the
ropelty and that all construction will conform to all existing state and local laws and will proceed in accordance with StIbmitted plans 1 am aware that the building
h"0J~" ''0 7t;;::RfbY "m thot th,,,~ o"''',J 01' d'~'O m3 '~' 31 th8PI~rty to p,,'olm n"d,d m~7J:'-I / ~tf
~ Signature Contractor's License No. Date
x
Permit Valuation ;:) 5'00, ---- I Park Support Fee
Permit Fee $ . ~/t.-i. '75'" SAC
Plan Check Fee $ I-d-~ Water Meter Size 5/8"; 1";
State Surcharge $ 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
This Application Becomes Your Building Pennit When Approved
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Paid
Date
Building Otlicial
Date
#
#
#
#
$
$
$
$
$
$
$
$
$ 7(",-
I Receipt No. 'f~J5~
I By (A-
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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
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 LA~
INSPECTIO~ NOnCE
ADDRESS ~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULAT~
INAL
~ITE INS EC I N
COMMENTS:
/
OATE TIME
SCHEDULED 7 :2 ~t) y
t{l.n '^.- ~~., ~
CONTR.
PERMIT NO.
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.
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 GASLINE AIR TST
o
'r\.l Co LJ. Jlk.(. .....
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE ORK, CALL FOR REINSPECTION BEFORE COVERING
Inspectol
Owner/Contr:
.Jso FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
fA.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
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