HomeMy WebLinkAboutBuilding Permit 04-0189
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please'!vpe or Print and sie;n at bottom)
ADDRESS $'03(,- j5lj.(rf
/L ~)l-111 51l.'p !J1Cl1tYL s
Date Rec'd
9.S.D3
; ~;~:' ~::y I PERMIT NO. /VI. /"If&a
3. Yellow Applicant l..F"r -4..1 J
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LEGAL DESCRIPTION (office use ooly)
IZ-20
LOT BLOCK / ADDITION "/, 111M-12.. CiLrsr R+/2..b<..
OWNERp . J
(Name) lllklf.- HomE0
(Address) f)-/S Mi.17fuJ~ P.tI4N
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BUILDER
(Name)
ZONING (offioeuse)
PtJO
PID z5. 4-Oz... 0 / Z. . ()
$U ITJ'_ / //tl .
(Phone) t5J -~SZ- - SZ-oo
EA6I111. /1111 oS/ z..1
sMJ1~
(!u12:l 'K1.A.bCH1LD
(Contact Name)
(Address)
TYPE OF WORK
J1!lMisc. &1IJ..O&n WALL.-.,
o New Construction
DDeck
(Phone)
(Phone)
DPorch
DRe.Roofing
tsl- '15Z- -SZ.OO
t,/Z -ZZl- 4/9..Y.s-
DLower Level Finish
o Fireplace DAddition DAlteration
PROJECTCOST/YALUE (excludiogland) $ -#/Yt7t7(:)
DRe.Siding
OUtility Connection
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 owner or
authorized agent for the above-mentioned property and that all construction will conform to all existing state and loca11aws and will proceed in accordance with
submitted plans. I am aware that the buildin official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
ente~ruponrhe,.,c.7to.~.r6.OY. needed' ctions. .-, /1. . /~
y 7.m;r- #'..w pc' - /}71 9' L'/ //J)
9' ./ /- - - --siW;~ture Contractor's License No. . /l::)ftte
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I Permit Valuation
J Permit Fee
I Plan Check Pee
I State Surcharge
I Penalty
j Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
1i /f"~tJ(), dO I
$ 'd'1..'? z.s-I
$ /'1().t:./ I
$ Cf,oeJ I
$ I
$ I
$ I
$ I
$ I
This Application Becomes Your Building Permit When Approved
~
.
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Building Official
1(Jlg~ 7
Date
I Park Support Pee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
Paid
Date
'-I Cf oJ. Kb
U-;:t?,-Lt
#
#
#
#
$
$
$
$
$
$
$
$
$ 4-'91,. fJJ&
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I Receipt No. Lf'hl..f aD
By /,'
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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.
1:) .\(( .U'\{-
Date Special Conditions. if any
24 hour notice for all inspections (952) 447-9850. tax (952) 447-4245
16200 Eagle Creek Aveoue Prior Lake. MN 55372
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DATE TIME
CITY OF PRIOR LAKE !Jj~ .;:; j
INSPECTION NOTICE SCHEDULED J; ~~y
/b'Y'r.:s- 7"--4'.",.... 6~c;;/ y .
ADDRESS ~j>.70 S'o2t: I- 1/9?.2 4~ IY' //4- .,.t;. /
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#RKSATISFA~{;""U
~ ~ CORRECT ACTION AND PROCEED
o CORRECT WORK, CAL FOR REINSPECTiON BEFORE COVERING
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
.
COMMENT~ /
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Inspector:
CONTR.
PERMITNO&<;I-/,(l;.f' /17'1. /?d 1-/9/
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
IItSNOTJ