HomeMy WebLinkAboutBuilding Permit 04-0626
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF Zvl \u \G COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
1_ While File
2_ Pink City
3 Yellow Applicant
I PERMIT NO. Oef-. 0 "Z-(p I
Zor..l (offi" ure)
I
(:.;~r;:dm~:~~llQa 'h1.
....J
LEGAL DESCRIPTION (office use only)
LOT
o"R
~e)
BLOCK
ADDITION
PID 1.S".. z.e4-. Ou,.O
(Address)
H;~hoQ / :T 1-10 !MO//f
/i./7(jt Cipn~(L U,
A/ /.4
(Phone)
95d497-.5d~
BUILDER
(Company Name)
(Contact Name)
(Phone)
(Phone)
(Address)
TYPE OF WORK 0 New Construction ODeck 'II!IPorch ORe-Roofing ORe,Siding OLower Level Finish 0 Fireplace
DAddition DAlteration DU~ty Connection 0 Misc.
CODE: ~.R.C. OLB.C.
Type of CODstruction: I
Occupancy Group: A B E
Division:
II
F
I
lliIV(!lA1fi)
H ~ M,(I) S U
2 W 4 5
PROJECT COST IV ALUE $
(excluding land)
I hereby certify thai I have furnished information on this application which is to the best afmy knowledge true and correct. I also certify that I am the owner or authorized agent for the
above-mentioned property and that all constmction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
9' con "yoke this mit r just ca",e FUrth~~ agree thatthe city official or a designee may enter upon the property to perform needed mspections,
( Contractor's License No. Date
/
I Permit Valuation "3000 .00 Park Support Fee # $
I Permit Fee $ 8A.Zs SAC # $
I Plan Check Fee $ 57. Sf. Water Meter Size 5/8"; 1"; $
I State Surcharge $ I. SO I Pressure Reducer $
I Pen aIry $ I Sewer/Water Connection Fee # $
I Plumbing Permit Fee $ I Water Tower Fee # $
I Mechanical Permit Fee $ I Builder's Deposit $
I Sewer & Water Permit Fee $ I Other $
I Gas Fireplace Permit Fee $ I TOTAL DUE I'A1Mro V. 't.~ .04-- $ /0/7,1/
This Application Becomes Your Building Pennit When Approved Paid i q-" 11 I ReceiPt No, <\- i C-"f4'1
~.~~ -#Z~(ocf Dale ~!d~Fr Bv ~ I
. Building Otlicial
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 a.. 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
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
:-:,,\~
PRIO'RLAKE
J
INSPECTION RECORD
SITE ADDRESS Jll?&.fl. ~ LA~f
NATURE OF WORK ~_~....ALt4
USE OF BUILDING S ,F: I).
PERMIT NO. a~ OfP 2-h DATE ISSUED
CONTRACTOR ~ IJ'. ~ PHON - l
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
(
INSPECTOR
DATE
I FOOTING
~k.~ I
I I
UNTIL ABOVE HAS BEEN SIGNED
OUGH - INS
I
J
Wr
V()
.>? -z
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
LDING
ELECTRICAL
C7tb
tv n 7: \C.
17 - Jr~
I
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrlCllt service cabinet prior to rough-in inspections
and maintained until all inspections hllve been approved. On buildings and additions
where no service cabinet is available. card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850
DATE nilE
CITY OF PRIOR LAKE I~
INSPECTION NOTICE SCHEDULED
ADDRESS r
OWNER CONTR.
PHONE NO. PERMIT NO. 4- /,,?J.p
o FOOTING o PLUMBING RI o EX/GRADlFILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
~SULATION o SEWER HOOKUP o FIREPLACE FINAL
FINAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
ol t llr~ ~~ v:lo
llo ii~/t.v
/
~RK SATISFACTORY. PROCEED
o CORR5'1 ACTION AND PROCEED
o COR1fZCjRK' CAll FOR REINSPECTION BEFORE COVERING
Inspectc cV-, Owner/Contr.
CI.JLI .9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
-::.......- .
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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