HomeMy WebLinkAboutBuilding Permit 04-0821
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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ADDRESS
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Date Rec'd
While
Pink
Yellow
File
Cily
Applicanl
I PERMIT NO. () t-(- C{ if ( I
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ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT/~BLOCK / ADDITION 4dCl/YI.cI U~ Lft:lt
OWNER
(Name)
Je'r _c;,1kc-v
/
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
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(Phone)
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(Phone) c;:::r?...2 SO S-G: S /
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TYPE OF WORK 0 New Construction DDeck DPorch ~e-Roofing ORe-Siding DLower Level Finish 0 Fireplace
DAdditJOn DAlteration DUtiIity Connegon 0 Misc,
CODE: OJ.R.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
J
E
II
F
I
IIIIVVA
H J M R
2 3 4 5
B
S U
PROJECT COSTlV ALUE S
(excluding land)
I hereby certify that I have fi.lmished information on this application which is to the best of my knowledge trUe and correct. I also certify that I am the owner or authOrIZed agent for the
above-mentIOned property and that all constr t will conform to all existing state and loca! laws and will proceed in accordance with submitted plans. I am aware that the building
:f""1 "0 "yok, Ihis P"~I' h"mm,. I hmby "~CO, th" Ih,,,ty om",1 ::.20'3 7W}~'rty 10 p"fmm O"g~O'.
, Signarure Contmtor's License No. D:t.
Permit Valuation ..J5ZX), ..-
Permit Fee $ 74- '2 "I
Plan Check Fee $
State Surcharge $ !-CJ.S--
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When Approved
Buildin!'.Otlicial
Date
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$ 1/-'-
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
#
#
Builder's Deposit
Other
TOTAL DUE
Paid
Date
'Iv-,-
K' ~- <.J
Receipt No. L/'7L/~ 7
By /')
~
ThiS IS 10 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 comtillltcs a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certlficate 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
CATE
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
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,
ADDRESS "Sl/ (pC)
.k &--JL \.J~--.>
OWNER
PHONE NO.
CONTR.
PERMIT NO. <+ . e,-:Z~
o FOOTING
o FOUNDATION
o FRAMING
~NSU,-^TIO~
INA4~
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
__,. N,.." ~Po...~
N NO PROCEED
K, ALL FOR REINSPECTION BEFORE COVERING
Inspec1I~: Owner/Contr:
cA - JJ.9850 FOR TH~EXT INSPECTION '14 HOURS IN AI:1VANCE.
CO RiQUlREME~ ARE FOR YOUR PERSONAL HEALTH ,{ SAFETY!
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