HomeMy WebLinkAboutBuilding Permit 04-0686
(Please tvoe or orint and sirm at bottom)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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LEGAL DESCRIPTION (office use only)
ADDITION ;\
OWNER /oJ-. ,
(Name)~i<"r
(Address)
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Date Rec' d
I PERMIT NOO l{ -~ .r~
ZONING (office use)
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(Phone) G, /2. -"5"<47- i( 3 qti'
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(Phone) h~ 1- 5dJ"7- -4'7 . (j
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(Phone)
BUILDER
(Company Name)~l1 en/i)) Tl\)(' 11 Gf~
(Contact Name) r-,,\ 'tv\. /V1A,ffl,,)51,v
(Address)~) Mr (Lell A.OnkJE. to.
TYPE OF WORK
o New Construction DDeck OPorch MRe-Roofing ORe-Siding
DAddition OAlteration DUtility Conne~ 0 Misc.
OLower Level Finish
o Fireplace
CODE: DI.R.C. DI.B.C. PROJECT COST IV ALUE $
Type of Construction: I II m IV V A B (excluding land)
Occupancy Group: A /-7 H I M R S U
Division: 2 3 4 5
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nished infor lion 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
nstruction will conform to all existing state and local laws and will proceed in accordance with submitted plans_ I am aware that the buildmg
Fu"h<emo". I h",by "'" ~h' c>ty.1?;0: a 26';-31;~ IPon th, pmp'ny to p"rmm needed m, t"" ~J
Signature Contractor's LIcense No. D te
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Permit Valuati9^
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
;;;?5""OO - I
$ 7q,/~ I
$ f -.;>- S-I
$
$
$
$
$
$
This Application Becomes Your Building Pennit When Approved
Buildinl!: Otlicial
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
Paid
Date
7(P ,
---7 - j(:' -if
# $ I
# $ I
$ I
$ I
# $ I
# $ I
$ I
$ I
$ 7fo. - I
Receipt No. l_/r /I-t1 ~ I
By ( :
cr----
ThIS IS to certify that tht' 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
i_~sued
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
ADDRESS
t:/r f/?
DATE TIME
SCHEDULED [~~
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CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o~c;p~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.,..e-FlIlA L
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS;-? /1
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If WORK SATISFACTORY, PROCEED
CORRECT ACTION AND PROCEED
o CORRECT WO;j..~'R REINSPECTION BEFORE COVERING
Inspector: /~ ___ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSHOTl