HomeMy WebLinkAboutBuilding Permit 04-1167
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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City
Applicant
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ADDRESS
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LEGAL DESCRIPTION (office use only)
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OWNER
(Name)
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(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
Date Rec' d
I PERMIT NO. t1l/ - Ilh '9
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ZONING (office use)
PID::J.IJ-t./(JO - b 1:.0-0
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TYPE OF WORK 0 New Construction DDeck DPorch ORe-Roofing ORe-Siding DLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection 0 Misc.
CODE: Dr.R.C, Dr.B.c,
Type of Construction:
Occupancy Group: A B
Division:
ill IV V A
H r M R
2 3 4 S
B
S U
PROJECT COST IV ALUE S
<excluding land)
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I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the OWOt'l' or authortZcd 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. I am aware that the building
official can revoke this permit for just cause Furthennore, I hereby agree that the city official or a designee may enter upon the property to perform needed Inspections.
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Signature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
I Plumbing Permit Feektlv~ $
I Mechanical Permit Fel $
I Sewer & Water Permit Fee $
I Gas Fireplace Permit Fee $
Park Support Fee
SAC
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34. 75'
-
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
.SD
4-O.()O
Other
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TOTAL DUE
This Application = ~~~._~~" Your Building Pennit When Approved
Paid '71',.7~f
Date /1./" -iI r
Building Otlicial
Date
# $
# $
$
$
# $
# $
$
$ /.(J()
$ 'I/, z.s-
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ThiS is to Ct.'rtify 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
L~slled
Planning Director
Date
24 hour notice for anlnspeclions (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /74/0 ~~/ao LJ~.
NATURE OF WORK L-OW!3/Z (,r61/E;&
USE OF BUILDING J3e.S ,4JL
PERMIT NO. CJ4-. / /& 7 DATE ISSUED II. /(, .04-
CONTRACTOR rO)( PHONE . 44 Z (,/.3~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
, THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
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PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
1/5RTl NG, / f :-
PeQt///ZED
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INSULATION
ELECTRICAL
PLUMBING
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
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FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
OCCUpy UNTIL ABOVE
NOTICE
This card must be posted near an electrical service cabinet prior to rough-In Inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
.
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HAS BEEN SIGNED
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FOR ALL INSPECTIONS (952) 447-9850
DATI! TIME
CITY OF PRIOR LAKE ~ /',. L
INSPECTION NOTICE SCHEDULED / .-!R1/~
ADDRESS /7f7c7 ~t'r NU k
OWNER
PHONE NO,
[] FOOTING
[] FOUNDATION
[] FRAMING
[] INSULATION
..efFINAL
[] SITE INSPECTION
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CONTR.
PERMIT NO.
[] PLUMBING RI
[] MECH RI
[] WATER HOOKUP
[] SEWER HOOKUP
,....en;LUMBING FINAL
,D-MECH FINAL
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[] EXlGRADlFILLING
[] COMPLAINT
[] FIREPLACE RI
[] FIREPLACE FINAL
[] GASUNE AIR TST
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~WORK SATI~T, I'''U\.I:I:U
[] CORRECT ACTION AND PROCEED
[] CORRECT ~;5 ;1"L FOR REINSPECTION BEFORE COVERING
Inspector. ~ OwnerlContr.
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CALL 447-9850 FOR THE NEXT INSPECTlON:U HOURS IN ADVANCE..
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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