HomeMy WebLinkAboutBldg Permit 04-1157
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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ADDRESS
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LEGAL DE ,CRIPTION (office use only)
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B~OCK
ADDITION
OWNER
(Name)
(Address)
BUILDER
(Company r- arne'
(Contact N a ne)
While
Pink
Yellow
File
City
Applicant
I PERMIT NO, 04-. //57
Date Rec' d
II. z.-. () f-
ZONING (office use)
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(Phone)
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(Address)
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TYPE OF V rORK D New Construction YfDeck DPorch ORe-Roofing
DAdditlon DAlter~n DUtility ConnectIOn 0 Misc.
CODE: ~. LC. DI.B.C.
Type o~o~s ruction: I II III IV V A B
Occupancy G roup: A B E F HIM R S U
Division: 1 2 3 4 5
[ hereby certify th It I have ti.lrnished information on this application which is to the best of my knowledge true and correct I also certify that I am the uwner or authOrized agent for the
abovc-mentlOned Jroperty and tAat 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 revo, thJS pert fi Just cause FUl1hcrmore, I hereby agree that the City official or a designee may enter upon the property to perform needed l~sPlctions. ,
X II . ________ '2 b:!. 1[,;> IL 0 II Z llYt-
,. Contractor's License No. Date
~I .
fjLj()1'I1J _ (') 0
$ jD'5.00
$ Ci,(o.IefS
$ 2.00
$
$
$
$
$
Permit Valuaton
Permit Fee
Plan Check F, 'e
State SurchafJ ;e
Penalty
Plumbing Per nit Fee
Mechanical P ~rmit Fee
Sewer & Wat, 'r Permit Fee
Gas Fireplace Permit Fee
This Applicat on Becomes Your Building Pennit When Approved
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.
!I//~r
I Date
l3uil1l1g011iCltll
ORe-Siding OLower Level Finish
PROJECT COSTlV ALUE $
(excluding land)
Park Support Fee
#
I1IJ
S<'~ll\..o
SAC
#
o Fireplace
1. m5~)
$
$
$
$
$
$
$
$
$
/7/.'7S"
Water Meter
Size 5/8"; 1 ";
WJ"'"
ThiS IS to certifY that the request in the above application and accompanying documents is in accordance with the City loning Ordinance and may proceed as requested This document
when signed by d~e City Planner consututes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
Pressure Reducer
Sewer IW ater Connection Fee
#
Water Tower Fee
#
Builder's Deposit
Other
TOTALDUE ~~ l"IZ",~4-1
IIU1~ I ReceiJltNo.
. //,l,L,JY Bu'
Paid
Date
Date
24 hour notice for all inspections (952) 447.98~O. fax (9~2) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any
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I
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PRIOR LAKE DEPARTMENT OF
I BUILDING AND INSPECTION
INSPECTION
RECORD
SITEADI)RESS IfoS4, l>UT(!.H "VE,
TYPE OF': WORK CEZ-a(" ec'tA~&Ji
USE OF BUILDING S. t=:"b - -
PERMIT NO, ()4-, /157 DATE ISSUED ~
BUILDER -E&e..n-. · PHONE ~ - ,,~O.- II'~~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
, FOOTING I INSP;;;; I /.eJ;~=r - l
cPLJ~CE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
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I FINAL I /Pf I 7p2/0S- ,
FOR ALL INSPECTIONS (952) 447-9850
,
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CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
7~J
L2:1c4 4e
SCHEOULEO
ADDRESS
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OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.--FfNAL
o SITE INSPECTION
COMMENTS:
-"
~1
~/i9
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o ~H FINAL/"
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o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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~~ORK SATISFACTORY, PROCEEO
I 0 CORRECT ACTION AND PROCEED
o CORRECT ~~5:-~ FOR REINSPECTION BEFORE COVERING
Inspector: /~ L--' Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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