HomeMy WebLinkAboutBuilding Permit 04-0691
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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LEGAL DESCRIPTION (office use only)
Date Rec' d
(P. z 9. ()+-
I, Wllite File I PERMIT NO I
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ZONING (office use)
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ADDITION
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OWNER
(Name)
(Address)
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BUILDER
(Company Name)
(Contact Name)
(Address)
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(Phone)
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(Phone)
(Phone)
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TYPE OF WORK o New Construction eck DPorch ORe. Roofing ORe-Siding DLower Level Finish o Firepl,e
DAddition DAltera on DUtility Connection o Misc.
CODE: 'ti::.c. OX.B.C. PROJECT COST IV ALUE $ \
Type of ction: X n ill IV V A B (excluding land) \
Occupan Group: A B E F H X M R S U ./
Division: 1 2 3 4 S \
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I hereby certify that I have furnished information on this application which is to the best army knowledge true and correct. I also certify that I am the owner or authonzcd agent for the
above-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans, 1 am aware that the building
official can revoke this permit for' t cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed mspections.
3-'1--00
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 $
~;B~Buildmgp7/~A~oved
Buildil1l! Oflicial ~ Date
Contractor's License No.
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $ J
Other $ I
TOTAL DUE $ /4.7/1
I I ,
I ~~o ~'2
Paid
Date
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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 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
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PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS ZSB~ "STZ) ~e:aesT PAl" N.cJ.
TYPE OF WORK tJE:bJ ~
USE OF BUILDING CS.F: O.
PERMIT NO. t:?4-, ofR q I DATE ISSUED ~! e "
BUILDER AYC-HOE:u"" ~ PHONE#'cal. 7G.S-U-':~2
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FOOTING . "71 :J ~a
PLACE N CONCRETE UNTIL ABOVE HAS BEEN SIG ED
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I"NAL I f!t 1f2}."J~/
FOR ALL INSPECTIONS (952) 447-9850
.
. .
DATE nME
CITY OF PRIOR LAKE /~
INSPECTION NOTICE SCHEDULED
ADDRESS .236fD S~~~
OWNER CONTR.
PHONE NO. PERMIT NO. q-G.r/
o FOOTING o PLUMBING RI o EXIGRADlFILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
~ FINAL o PLUMBING FINAL o GASUNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
~~RKSATlSFACTORY,PROCEED
o CORRECT TION AND PROCEED
o CORRE RK, CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr.
C
R THE NEXT INSPECTION 24 HOU S IN ADVANCE.
QUJREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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