HomeMy WebLinkAboutBldg Permit 04-0243
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
White File
Pink City
Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
/+710 ~()V6
/11/~N(/C
-
S.~.
LEGAL DESCRIPTION (office use only)
LOT 3 BLOCK
ADDITION j::;,vt;FtPSC-YS c,of/6
OWNER
(N ame)
POTJ"r~1 S7~1/6 <
6fJVL&
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
Date Rec' d
If. q. O~
PERMIT NO. 0" ~ oZ43
ZONING (office use)
Je,15D
PID z,6. II". 003.0
094-. +z04-
TYPE OF WORK D New Construction DDeck DPorch 'l2Re-Roofing b(Re-Siding DLower Level Finish D Fireplace
DAddition DAlteration DUtility Conn~n D Misc.!'
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
III IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST IV ALUE $
(excluding land)
I
E
II
F
1
I hereby certifY that I have filrnished I formation 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
above-mentIOned property and that I onstructlOn will c form to all eXisting state and local laws and will proceed In accordance With submitted plans I am aware that the building
;''''' can revok, th" ""m':u 'dJJO rt : ,. h'~bY ,wee th" th, 'ny olli,i,l 0' , d"'gnee nuy ent", upun th, prop,rty to ",lform need,d m'/Y'kj ?/o CL
.~ Signature 9 Contractor's License No. ~a~e /
Permit Valuation 2,500.00
Permit Fee $ 1~.7S-
Plan Check Fee $
State Surcharge $ /.25
Penalty $
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 Permit When Approved
/f(,.OO
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Paid
Date
Building Otlicial
Date
# $
# $
$
$
# $
# $
$
$
$ 7(,. 00
n
Recei~;No. 4--h~b
By / __ J
0
ThIS IS to 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 constItutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Certificate 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
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED tf,!/~r
(}u e ~.k.-
ADDRESS
,1t/7?C
CONTR.
OWNER
PERMIT NO.
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
()?j -,;2-Lf3
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: t. /' /' /
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rVWORK SATISFACTORY. PROCEED
A ~ORRECT ACTION AND PROCEED
o CORRECT WORK. crY-I$!( RE~SPECTlON BEFORE COVERING
Inspector: ,f/tA/ '-"""'"", Owner/Contr:
CALL 447 -9850 FOR THE NEXT INSPECTION 24 HOURS)N ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INS1#orl