HomeMy WebLinkAboutBuilding Permit 04-0025
(Please ~e or mint and sign at bottom)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
I. IS. ()4-
). While File I PERMIT N() I
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LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER C L
(Name) r-C1~j ~\)"Icl
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
o New Construction
~Lower Level Finish
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DDeck
ZONING (office use)
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PIDZ5: 3/2- . 001. ()
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(Phone) '1">)
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(Phone)
(Phone)
DPorch
ORe-Roofing
o Fireplace
OAddition
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PROJECT COST IV ALUE (excluding land) $
[ JRe-Siding
I JUtility Connection
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also cert fy that I am the owner or
authorized agent for the above-mentioned property and that all construction will conform to all existing state and local laws and will p 'oceed in accordance with
submitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city Jfficial or a designee may
exnter u~n the ~opei)' t~E.erform needed inspections.
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I /" Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
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$ t. z..z.s
$
$
$
$
$
$
$
1.0 0
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This Application Becomes Your Building Permit When Approved
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Building Official f bate
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
Paid /0 f"". z,>
Date J_ /f". 0 ~
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$ /04. Z5'
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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 procee< as requested. This document
when signed by the City Planner constirutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Ce tificate of Occupancy must be
issued.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 1$3 hO <SV11UJ6./JEIe..- 61 j~
NATURE OF WORK LO IN ~ LeV6(___
USE OF BUILDING leES rr/ ~
PERMIT NO. 04-. (JOz.-s I'DATE ISSUED /. IS. O<;~
CONTRACTOR LD VO L.D PHONE--.Z 2..G:. fD 2-0 ()
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DAn
I I
I I J
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGtIIED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNEU
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
fitd i ,f//;O/;y
\f/
OCCUPY UNTIL ABOVE HAS BEEN SIGNIED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspel :tions
and maintained until all inspections have been approved. On buildings and add tions
where no service cabinet is available, card shall be placed near main entrance. .
-.
FOR ALL INSPECTIONS (952) 447-9850
DATE TIME
SCHEDULED ~~
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/2t;()
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~L
o SITE INSPECTION
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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/ WORK SATISFACTORY, PROCEED
/ ~ :ORRECT ACTION AND PROCEED
PECTION BEFORE COVERING
./" I
:S:~O:ECT W~LL FOR REI
Owner/Contr:
CALL 447-9850 FOR T E NEXT INSPECTION 24 HOURS IN ADVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!