HomeMy WebLinkAboutBldg Permit 05-0812
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
B . 2.. Z. 05
While
Pink
Yellow
File
City
Applicant
I PERMIT NO. OS.08/7- I
Please
e or trint and si
at bottom)
ADDRESS ZONING (office use)
b /5 {l/44N'r t$wzr A!W
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
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cA...
(P~e) f/f'~- 5tJ.s-:r
(te(~ ~/,2-Sfj().3oos-
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction Deck DPorch ORe-Roofing
DAddition DAlterat n DUtility ConnectIOn
CODE: ~I.R.C. DI.B.C.
Type of Co'nsttiUction: I II III IV V A B
Occupancy Gr~up: A B E F HIM R S U
Division: 1 2 3 4 5
ORe-Siding DLower Level Finish
D Fireplace
o Misc.
PROJECT COST IV ALUE $
(excluding land)
] hereby certify that I have hlrnishcd mformation on this application which is to the best of my knowledge true and correct. I also certify that [ am the owner or aulhonzcd agent ll)r the
above-mentIOned p . erty and th~lI co ruction will conform to all existing state and local laws and wil1 proceed in accordance with submitted plans. I am aware that the buildmg
ntliCla] can rev() IS ermll ~ st _ Furthermore, I hereby agree that the cay offiCIal or a deSIgnee may enter upon the propelty to perform needed inspectIons
X . - t9'~ K-.2;l-~6
Signature Contractor's License No Date
Permit Valuation 0 . f) 0
Permit Fee $ .2.S
Plan Check Fee $ :34-
,
State Surcharge $ I, 'i>cj
Penalty $
Plumbing Permit Fec $
Mechanical Permit Fee $
Sewer & Water! Permit Fee $
Gas Fireplace Fermit Fee $
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 $ /L/7, II
~~
BuiluUH!.Otflcial
i'/Z'5/0'5
. D,lle
Paid
Date
/+--;_~I
8 z.? (.~
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/
This Application Becomes Your Building Pennit When Approved
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 cunstllutcs a temporary Certificate of Zoning compliance and allows constmction to commence Before occupancy, a CertIficate llf Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspectIOns (952) 447~9850. fax (952) 447.4245
16200 Eagle Creek Avenue Prior Lake. MN 55372
""
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS /s'1-/5 C;e/!NE c.oUt0r 11/11/'
TYPE OF WORK 06C.K-
USE OF BUILDING K-E;S /l/IL
,
PERMIT NO. 05. 0 81 L- DATE ISSUED 8 Z Z. oS-
BUILDER j3 /0/'1 N ff/1/cL?6/C PHONE # 447. 50S?
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
I FINAL
PI3
,
1/;1~~
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS 15~ (<;;
OWNER
lo/~T6J
, C-t
-
SCHEDULED
Ct-t; .
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
-EANSULA TI.'ltl. ? .
~INAL \...J..e.C.- '-7
. 0 SITE INSPECTION
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
TIME
)"- 81'2-
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RJ
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~RK SATISFACTORY, PROCEED
o CORRECT TION AND PROCEED
o CORRE T RK. CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr
C
THE NEXT INSPECTION 24 HOURS IN ADVANCE.
MENTS ARE FOR YOUR PERSONAL HEALTH .( SAFETY/
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