HomeMy WebLinkAboutBuilding Permit 04-0401
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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(Please type or print and siltll at bottom)
ADDRESS
3/22-- S;-moy
LEGAL DESCRIPTION (office use only)
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 01--.04-0 I
Ut/6 ;2r.
LOT 20BLOCK
I ADDITION NO/G47lWc~}) O/fU- S 2rJ1.7
PID ze. 37/.02..0. 0
OWNER
(Name)
. ~c(J {
Ne.. '\
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
Ri~/L
Date Rec' d
5. f.o .04-
ZONING (office use)
ICISO
(Phone) 6~J- Us -/2-.7. V
r 6g~
CIY" - ~
(Phone) tlZ -lf23 - /PZA
(Phone)
TYPE OF WORK 0 New Construction 'I'11eck DPorch ORe-Roofing ORe-Siding DLower Level Finish D Fireplace
DAddition DA1te~ DUtiJity ConnectlOo 0 M1SC.~
CODE: ~I,R,C. OLB.C. ~ hm. ~ ~CTCOST/VALUE $
Type ofcfo"nstroction: I II III IV V A B (exdnding land)
Occupancy Gronp: A B E F HIM R S U
Division: 1 2 3 4 5
I hereby certify thai I have furnished informati n 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-men ' lai'"aJl>co lIOn Will conform to all eXlStmg state and local laws and will proceed In accordance With submitted plans I am aware that the bUilding
:fi"'J~Ok -=:~,':: Furthe,mo". I hmby "'" ,""th, "'y offi",J "" d'<<goe, may entet opon the pmpetly to p,tfotm n"?Ah ~
/ ~ Slgnature Contractor's LIcense No ;tate
J/.-9'V L- /V& L
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1/7. ? S
7f4.-St1
2.5'"0
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
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
Paid
Date
->(::1
/ I
L(
I~~.
1r1&
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This Application Becomes Your Building Pennit When Approved
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131l1Idlll.!! onicwl Dale
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$
$
$
$
$
$
$
$
$
Ic/c"79
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'hiS 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
,hen 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
sued
Planning Director
Date Special Conditions, if any
24 hOUf notice fOf all inspections (952) 447-9850. fax (952) 447~4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
.,
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS 3/2 Z SI-#fO,/ ~oV6 PT.
TYPE OF WORK Of71L / ~nJff- ~~/tf (7)b3"rG#
USE OF BUILDING 11.L;5 I-//~
PERMIT NO. () ~. 0 40 I DATE ISSUED 5. (P. 04"-
BUILDER #6/ PHONE# (P~/. 1.(,.]./Z34-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
, FOOTING I q ~PECTOR I h _\ 1) DATE
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I I
I FINAL
,
M~
o V
lII~c
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 3/;0 :;1-.uL.. a~
Q
OWNER CONTR.
PHONE NO.
lJ FOOTING
o FOUNDATION
o FRAMING
o INSULATION
'Ill FINAL
I[J SITE INSPECTION
PERMIT NO.
lJ PLUMBING RI
o MECH RI
o WATER HOOKUP
lJ SEWER HOOKUP
lJ PLUMBING FINAL
o MECH FINAL
DATE
Irft/d
nUE
C( - (("I
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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H:.>~ I~J\
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~RK SATISFACTORY. PROCEED
o CORREC CTION AND PROCEED
o COR C K CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
7.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INVlOTl