HomeMy WebLinkAboutBldg Permit 04-0716
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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File
City
Applicanl
I PERMIT NO. 0"", () '1 / ~ I
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fr/ () r ~. #11 ~f37;z
LEGAL DE ,CRIPTION (office use only)
LOT'i B"OCK:J- ADDITION J'J-)
A/od), ~~prf tOtI' kt;
PID J{ ,tStl1f'ClI.J 90
cg,=~'J~dd/P/~ /( 'll.d 5qJ.oI~ 5 )ll0'4fr(PhOne) 9s:z.
(Address) /tf/~{P A~L e; }..c--I", )/~) b'" ~ j.,qk~, Aw
BUILDER f I /
(Company" ame)------{.!1f? U:{ e /') l.uk e ~
(Contact Na ne)
(Address)
")
/
(Phone)
(Phone)
Date Rec'd
7./4'.(J4-
ZONING (office use)
~(
'1'iS-q-3? 7
S137P1
TYPE OF V 'ORK
/}~A/t:i[lF' ra;/"~ (~j,.
o New Construction ~eck ~Porch ORe-Roofing e-Siding
DAddition DAlteratlOn DUtility Connection 0 Misc.
P)C,,o t; if h.5t-"j f> e.k
DLower Level Finim' 0 Fireplace
I hereby certify th It 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 allthonzed agent for the
above-mentIOned }roperty an hat all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware thallhe buildmg
:",j, "VOk';:1)" JUst JP Furt "mo". I h",by 'gte, ~ om,;,j u" d"'goee m,y en", upon the pmpetly to p"fo,m need,d m,~;ui..;? t:'JO Y'
- J7$ignature I Contractor's License No. Date
I
600.00
25. 00
If,. z.S-
"({V
CODE: 01. LC. OI.B.C.
Type of Cons roction:
Occupancy G coup:
Division:
A
Permit Valuat .on
Permit Fee
Plan Check F ,.
State Surchar: :e
Penalty
Plumbing Per nit Fee
Mechanical P ~rmit Fee
Sewer & Wat ~r Permit Fee
Gas FireplacE Permit Fee
B
4'/.75
I Receig'4~'7z 7'V
By ~~ .
f
I
E
PROJECT COST IV ALUE $
(excluding land)
II
F
I
III IV
H I
2 3
V
M
4
A
R
5
B
S U
Park Support Fee
#
$
$
$
$
$
$
$
$
SAC
#
Water Meter
SizeS/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
#
#
Builder's Deposit
Other
TOTAL DUE
7/1 ,+10 'I
Date ,
I Paid
Date
"l- /. 7 '3
7_/~.o~
~ -:(.
0/-
This Applicat on Becomes Your Building Pennit When Approved
---
Btlilrlt1!!OIliCial
ff)tJ
$
$
$
$
$
$
$
$
$
ThIS is to certify ~hat the request in the above appIicallon and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requt'sted. ThIS document
when signed by t~e Clty Planner constJIutes a temporary Certificate of Zonmg comphance and allows constructIOn to commence Before occupancy, a CertIficate of Occupancy must be
~ued ' '
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
"
PRIOR LAKE DEPARTMENT OF
. BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS / ~/5b AsH CI;eu& /lie
TYPE OF WORK 1Z6Pt-/-'lu:;; O&K- /&'9/t-/ NG
USE OF BUILDING u.r R/~' (
PERII1ITNO. O(-,07/(p , DATE ISSUED "7./4-=04-
BUILDER /-f1:lVt!A/l-~1 PHONE # I fS 4-387
,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
~ I I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I I
I-FINAL
41
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FOR ALL INSPECTIONS (952) 447-9850
CrN OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS , L( I r:::t n
Ac.l.. (1, r
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULA Tlql>lL / ~
~7NS~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
DATE TlME
~-If-cJ'T
4. 7/("
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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XWORK SATISFACTORY, PROCEED
o CORRECT ACTIO AND PROCEED
o CORRE W CALL FOR REINSPECTION BEFORE COVERING
Inspeelo
Owner/Contr:
CAL 5 OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
...-/
LU"I:. xI:.QUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY/
INSJIIOTl