HomeMy WebLinkAboutBuilding Permit 04-0667
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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(Please type or print and sism at bottom)
ADDRESS
;72/7' .hJ/; /},/j,-;T .-A"',! ~.
E,
LOT 7' BLOCK
LEGAL DESCRIPTION (office use only)
White
Pink
Yellow
File
City
Applicant
ADDITION /lpyt"'-> ./ ~ -L<>7/rr= A~
OWNER
(Name)
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M,.J /r/
(Address)
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(Phone)
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BUILDER
(Company Name)
(Contact Name)
(Address)
. 5/7/'/ F
(Phone)
(Phone)
Date Rec' d
7. /, ()4-
I PERMIT NO. 04-. D(,(,7 I
ZONING (office use)
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PIDZO: O.3q O/tJ.O
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TYPE OF WORK 0 New Construction DDeck DPorch ORe-Roofing ORe-Siding DLower Level Finish 0 Fireplace
DAddition OAlteration DUtility Connection 0 Misc.
CODE: flli.R.C. DI.B.c.
Type of Construction: I
Occupancy Group: A B E
Division:
II
F
I
IIIIVd:JA~
H~Ml1PSU
2 ,<.;t) 4 5
PROJECT COST IV ALUE $
(excluding land)
I hen'by certifY that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that 1 am the owner or authonzcd agent for the
above-mentIOned property and that aU construction wiIl co rm to all existing state and local laws and will proceed in accordance with submitted plans. 1 am aware that the building
official can nltoke this permit ust cause Furthermor ~ y agree that the city official or a designee may enter upon the property to perform needed Inspections
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Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$~.9(!)
$ 7'3.75
$ tl7. ~t.f
$ j,()O
$
$
$
$
$
This Application Becomes Your Building Pennit When Approved
~~
Buildlllg Otlicinl
. 7/1/0<(
Date '
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid In.'''
Date I.- I. d 4-
# $ I
# $ I
$ I
$ I
# $ I
# $ I
$ I
I: I ZZ. 109 :
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ThiS IS Iu certify that the request in the above applicatIOn and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constltutes a temporary Certificate of Zoning compliance and allows construction to commence Before occupancy, a Certlficate of Occupancy mllst 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
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PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITEADDRESS -1S21L( Fi5M f'()\~'" eo.s.€',
TYPE OF WORK ~E~ t:>atl-
USE OF BUILDING -,. F: D ·
PERMIT NO. 04-.-0c,(p ( DATE ISSUED
BUILDER~~1L..A. v~,,-. PHONE #9J~-I(t(~-.z7'f(
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSP,~CT:'J ~TE "
I FOOTING I /lVr I 7/'R/O'Lj
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I I
I FINAL
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FOR ALL INSPECTIONS (952) 447-9850
.
DATE nMe
CITY OF PRIOR LAKE //J/. ., L
INSPECTION NOTICE SCHEDULED ~ 'l
ADDRESS /r~/~ h1"/ d~ I 4/
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
AfiiNAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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/t/I L e
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o EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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~OR~TORY.P~
o CORRECT ACl"". "..u ...~OCEED
o CORRECT WOR':, ~~OR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
.
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INS1<<JTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .l SAFETY!