HomeMy WebLinkAboutBuilding Permit 04-0687
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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City
Applicant
I PERMIT NO. o+: 0 (,87
(Please me or print and sien at bottom)
ADDRESS
.r::r/1
Co /JJ(
Love ///b/ S r'
LEGAL DESCRIPTION (office use only)
LOT Z-!BLOCK
ADDITION cY/1VOI/ ~V6 fJlf1e.k:-
PID ZS. 07..7. IJ 17 _ I)
OWNER
(Name)
(Phone)
(Address)
Date Rec' d
7. 8,04-
ZONING (office use)
1tU..J J:)
BUILDER I / / / . // L/, U1, \
(Company Namet 11(j11./f1(fJ/"/<..... /7()",(./
(ContaetName) f){)i//c1 L~OSi!#'!
(Address) /q().fJ WO/lr) 4 5. IjLl.l'/J3v/~
(Phone)
(Phone)
qJ:2. 992. )(0") 0
TYPE OF WORK. 0 New Construction DDeck DPorch 2(Re-Roofing ORe-Siding DLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection 0 Misc.
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
mrvvA
HIM R
2 3 4 5
B
S U
PROJECT COST IV ALUE S
(excluding land)
I
E
II
F
I
I hereby certify that I have furnished information on this application which is to the best of my knowledge tme and correCl. I also certify that I am the owner or allthonzed agent for the
above-mentIOned properly and that construction will conform to all existing state and local laws and will proceed in accordance with submitted plans_ I am aware that the buildmg
:T~m;; pcem>l fm '"u'" Fmthcemo". I h"'by "~CO, th" th, my offici,[ m, d"',nee m,y "", upon th, pwperty to pcefmm 7~d &YO~
..- Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penally $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
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
This Application Becomes Your Building Pennit When Approved
7',0 j)
'1 ~ 11-84
, [
I ~eeeiP(bto.
y!,.
Paid
Date
Building Otlicial
Date
$
$
$
$
$
$
$
$
$ 7("dO
.,..7 z,.r t;
ThIS IS to certify that the reqllest 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
~lr TIME
O/t,'l ao~ 7//.
CONTR.
o t/ -rdY7
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
SS/.,2
OWNER
PHONE NO.
PERMIT NO.
o EltIGRADlFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
ir'FlNAL 0 PLUMBING FINAL
/0 SITE INSPECTION 0 MECH FINAL
COMMENTS: // /)
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, all .~~
~ORK SATISFACTORY, PROCEED C ~ /~
/'~ CORRECT ACTION AND PROCEED I
o CORRECT W~~'Yl> FOR REINSPECTIOI<<u;FORE COVE
Inspeclor: j/f/l-/ J--. ' Owner/Con!r:
CALL "7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETYI
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