HomeMy WebLinkAboutBldg Permit 05-0459
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
--
5. 20/05
File
ntl'
Applicant
I PERMIT NO. ()~. 04-51 I
White
Pink
Yellow
(Please ~pe or pr nt and sign at bottom)
ADDRESS
2979 /J01fCfiT ~/L--
LEGAL DES, :RIPTION (office use only)
LOT (I)BL XK 3ADDITION
II -I~ ft 2.r,
=.=.-
PID25."" 382.. ()b 9. ()
OWNER~::>'
(Name) \ "t'\Al
(Address)
"t ,<.. \J '" 1. ,i:rel r:'
,
ZONING (otTiee use)
/CI
(Phone)
Z.0'5-(,!i7- V9:Z(
vJtL!\l lEe
BUILDER
(Company Nane)
(Contact Nam ,)
(Address)
(Phone)
(Phone)
\.....--
TYPE OF WCI)RK. 0 New Construction DDeck DPorch ORe-Roofing ORe-Siding ~wer Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection ~
CODE: DI.R C. DI.B.c, o Misc.
Type of Constr Iction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Gr< up: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
l
I hereby certify that [ haw hlrnished mformation on this application which is to the best of my knowledge tme and correct. I also certify thaI I am the owner or authOrized agent for the
above me ' and that all constructlOn Will conform to all eXisting state and local laws and WIll proceed In accordance With submitted plans I am aware that the buildmg
l)!fiClal an revoke tJ IS per r )t~ cause F~elmore, I hereby agree that the City offiCIal or a deSignee may enter upon the property to pel form needed l~cctJ()ns ,
X ~VZ- (. N./T --:::::,. 5/~"~r
~ Signature Contractor's LIcense No Date
Gas Fireplace F ermiyFec
Thimrk'
- ilU;ld,I'"Otli,;,,,
ThiS IS to certify th, I the request in the above applicatlOn and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requcsted ThIS document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence Before occupancy, a Certificate (If Occupancy mllst be
issued
Permit Valuatic n
Permit Fee
3,000.00
$ '74.75
$
$
$
$
$
$
Other aE C-77Z-t (!/f L
TOTAL DUE
Park Support Fee
SAC
#
#
Plan Check Fee
-
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee #
State Surcharge
Penalty
Plumbing Perm.t Fee
Mechanical Per nit Fee
Sewer & Water Pennit Fee
ISO
40.fJO
Water Tower Fee #
Builder's Deposit
$
)//;,~s
K-;:;.7- '\
Paid
Date
Receipt No,
By
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
$
$
$
$
$
$
$
$ /. () 0
$ //7 ZS
'/y/<o /
~.
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS ,4.,
NATURE OF WORK UJISL,
USE ~F BUILDING Ah'
PERIAlT NO. IJ D~E ISSUED 6...,tr
CON'rRACTOR PHONE~t#fZI
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING ~ND INSPECTION
INSPECTOR
DATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
p/y
I .
\vJ
v
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUII.DING
ELE CTRICAL
PLUMBING
HEATING
DO NOT
VV0"
Sf, '-'S" /Q'('
vVV/
v1-r7
OCCUpy UNTIL ABOVE HAS BEEN
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.
8" /K, ~
9r-K-45
SIGNED
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
~q7q
f1 ) t,~ J.A-J-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION / J
..IiI"'FlNAL (,.....-1'-(
o SITE INSPECTION
o PLUMBING Rl
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~------
~~
/' / r
I I ~/jx
~ ~
----
DATE TIME
5i..J.S-'0S'
,s:-. '15"""1
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
-=---
.......
r- J
/- [ l e.
~
~
./
~RKSATlSFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~O~. ~W REINSPECTION BEFORE COVERING
Inspector: jI f/ / --- Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lN$/mrI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/