HomeMy WebLinkAboutBldg Permit 05-0521
(Please type or print and si2D at bottom)
ADDRESS
I l./ L(, C)
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(l ~~ t--L,
LEGAL DESCRIPTION (office use only)
LOT II BLOCK , ADDITION
OWNER
(Name)
~c-~sL
S ----e..
BUILDER ,
(Company NameL u...~ tt--C
(Contact Name) '?- ~ ,~
(Address) 20 ~/b ::J~ \~
TYPE OF WORK 0 New Construction ~k OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditlOn OAlteration OUtility ConnectIOn
(Address)
A-S
Date Rec'd
CR .S 05
I Whit~
Pink
:J Yellow
hie
City
Appl;cant
I PERMIT NO. ()-!;-. OSz I
ZONING (office use)
G.~~___
(~
nD77?oW VI t;;"J
1::.'2-
PID 25. .384-. 0 f(. 0
(Phone) <15'2.. - 4. L\ l:;"'. cJ<:.,3.:,
~ '^'""-
C'--f.> \-v..- \3.';, \-6k~
<
~ k~IILL
(Phone)
(Phone)
IY"/
"151.- -<iB~ - S-::'-/0
I..~ -~~o -"Z...c.."lL
~~~iL.j
CODE: ~.C. DI.B.c. D Misc.__
Type of onsttUction: I II III IV V A B PROJECT COST IV ALUE $ j,o-e.e,
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I herehy certify that I have hlrnished mfurmation on this application which is to the best uf my knowledge true and correct. I also certify that I am the owner or authOrized agent for the
abllve.mentlOned prnperty and that all construction will conform to all existing state and locallaw$ and will proceed in accordance with submitted plans I am aware that the buildmg
~T1Ci\~5>vo_ke thTJi;llS<:e~;::l'bY ag:that !he Clry official 31;es::;:z:; 118 t~p;p~t;:;) pertlJrm need~ I:~jti(:~o S;
(~ Signature I Contractor's License No Date
...,~- _.J
:&::COadingp~;:(~:oved
Permit Valuation
Permit Fee
Plan Check Fce
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
Buildinl! Onicial
'\
1'-3000,00
$ APi. z.s:-
5'7. ~G.
1.,>0
$
$
$
$
$
$
$
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$ ILl7.!/
Water Meter
Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid
Date
147. II
(ot .3 &r
Receipt ~o. 4~':r44-
Bv /ue-
/
Date
ThtS IS to certify that the r<~quest in the above applicalion and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed a.~ requested ThiS document
when signed by the City Pbnncr constitutes a tcmpor;uy Certificate of Zonll1g cumpli,mce and allows construction to commence Before occupancy, a Cel'tlficate of Occupancy must he
issued
Planning Director
Date
24 hOllr 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
INSPECTION
RECORD
SITE ADDRESS J4-cf 7 () t!AflL-C G/'f'!E. W~
TYPE OF WORK ~6C!.1c... I
USE OF BUILDING IZ8I rl/n..-
PERMIT NO. or,oszl DATE ISSUED 0.3. OS-
BUILDER #~/1/.o PHONE# q~ S90
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR .~TE /
I FOOTING I ~ I ~1/~d5
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN'SIGNED
,..... I I
I FINAL
h?!7
-
If/-,d ~
_ v-
FOR ALL INSPECTIONS (952) 447-9850
'i
~"'-'--'---~'----
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS I '-/ LI7 /)
OWNER
PHONE NQ
..._~
~~~~;TION
o FRAMING
1 INSULATION
. . ..AL
o SITE INSPECTION
COMMENTS:
()l
DATE nME
SCHEDULED &1*
C.~G,~L .
CONTR.
PERMIT NO. 5- 6 Z/
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
1\
JD
Co~ (~ Dk
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORR RK, CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
'MENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
lNSNOTI