HomeMy WebLinkAboutBldg Permit 04-0737
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
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Yellow
File
City
Applicant
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LEGAL. jDESCRIPTIO. N (office use only) a )
LOT J BLOCKX ADDITION ~uJOO'CL
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OWNER '} .. L (\ V-
(Name) LJ~ ~)l/\~ HO\-Vtt.1L
(Address)
BUILDER \ _""). , \ \
(Company Name) "~..' ...' IbV\ Y1~
(Contact Name) ~\n ~~<fl ~
(Address) "~{ E' ~() ~\
(Phone)
Date Rec' d
PERMIT NO. CJ'I~ /j3~1
ZONING (office use)
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PID d6 - cJ3~" ();) 2J "6
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('~'M}(~~ ~ (Phone) 9Q:JS-y~~(7
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TYPE OF WORK 0 New Construction ODeck DPorch ORe-Roofing ~Siding
OAddition OAlteration OUtility Connection 0 MiSC.~
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
II
F
I
III IV V A
HIM R
2 3 4 5
I
E
OLower Level Finish
o Fireplace
B
S U
PROJECT COST IV ALUE $
(excluding lpid)
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I hereby certi .tha It have fi.lqis (J information on this application which is to the best of my knowledge true and conect. I also certify that I am the owner or authorIzed agent for the
above-menl1O ed ,0Plry an t t all construCl1on WIll conform to all eXlstmg state and local laws and Will proceed m accordance wIth submitted plans I am aware that the bUlldmg
:ficiaI can r ~ h~ l;::::t 0 Just cause F1111hermore, I hereby agree that the Clry OffiCl~~re \m~nter upon the property to perform needed mspectlOns
'\, - · Signature Contractor's Ltcense No. Date
Permit Valuation ;;lS-()O, -- I
Permit Fee $ iL/,'!? I
Plan Check Fee $ i ,051
State Surcharge $ I
Penalty $ I
Plumbing Permit Fee $ I
Mechanical Permit Fee $ I
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Buildlllg Ollicial
Date
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid (& ..- _
Date '7-d20...-Q
# $
# $
$
$
# $
# $
$
$
$ I' (p -----
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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 conSl1ll1tes a temporary Certificate of Zoning compliance and allows construction to commence. Before Dccupancy, a Cel1ificate Df Occupancy must be
issued
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
PHONE NO.
DATE TIME
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CONTR.
PERMIT NO. 6 ~-- ?$7
SCHEDULED
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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~ORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~~;;}pR REINSPECTION BEFORE COVERING
Inspector: #~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl