HomeMy WebLinkAboutBuilding Permit 04-00676
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
&, L/3.G4
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
WIlile
Pink
Yellow
File
City
Applic~nl
Date Rec' d
I PERMIT NO.O'l- c:, 7 ~
ZONING (office use)
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TYPE OF WORK 0 New Construction DDeck DPorch ~Re-Roofing ORe-Siding DLower Level Finish D Fireplace
DAddition DAlteration o Utility Connection 0 MIsc.
CODE: DI.R.c. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
II
F
1
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HIM R
2 3 4 5
I
E
P fto<JC1Yn/-f Sf"
(Phone)
(Phone)
(Phone)
B
S U
PROJECTCOST/VALUE $
(excluding land)
aye furnished information on this application which is to the best of my knowledge tme and correct. I also certify that I am the owner Dr authonzed agent for the
fry and that all construction will conform to all existing stale and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
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Slg re Contractor's LIcense No tJate'
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Permit Valuation ~")OO I
Permit Fee $ /t;-1.~ I
Plan Check Fee $ I ifS 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 Otlicinl
Dnte
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
Paid ] {"
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# $
# $
$
$
# $
# $
$
$
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By {.
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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 documen!
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) 447-98S0. fax (9S2) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any
DATE TIME
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
~SULATION
FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: /h-7' ()
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
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o CORRECT ACTION AND PROCEED
o CORRECT WOR:JJ-V'R REINSPECTION BEFORE COVERING
Inspector:}/tff/ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNO"
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!