HomeMy WebLinkAboutBldg Permit 05-0769
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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City
Applicant
(Please type or print and sign at bottom)
ADDRESS fl )
3..~ 1 5 V~5w~oJ LIe.clQ. S~ \ Rl\jQ.. Wu
LEGAL DESCRIPTION (office use only)
LOT 19 BLOCK <-1 ADDITION WI}. \)\~ s
~ 'f~ AckL-h ~~
OWNER- tI
(Name) \1.r~d~
(Address) 3.0 1 S-
f;'I5!:~eC'd
I PERMIT NO. t)!J--7(P Cf
ZONING (office use)
PID 2.S' - ~1f - 0,/ {J-C)
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(Phone) 3o--a-tjLlI-1IS4
~lHLL l ~ G fY'---kj S~::l
BUILDER
(Company Name)
(Contact Name)
(Address) ,1 L'l...D
~
(Phone)
(Phone)
.s~3tS'l
k. G'J ~A_~______
~-\~(~~ l\~ J -r~~
'-14 \" - J)lJ3~
CODE: ~.R.C. DI.B.C. ~ Mise.
Type of onstruction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5
ORe-Siding OLower Level Finish 0 Fireplace
, /
1/ U-.t6 M~ &n tlm....- ~-.J
PROJECT COST IV ALUE $
(excluding land)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
DAddition DAlteration DUtility Connection
I hereby certify that I have nlrnlshed mformation on this applical10n which is to the best of my knowledge true and coITect. I also certIfy that I am the owner or authOrIzed agent for the
abiJve-menl1oned proP9{ty and that all construction will conform to all extsl1ng state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
:f~n ~e ::bL~;:C'l cause Flllthelmore, I hereby agree that the CIty offiCIal or a deSIgnee may enter upon the property to perform needed mspectlOns
~v Stgnature Contractor's Ltcense No Date
Permit Valuation
!rltJ. ()()(). 00
$ , /q /. SO
$ I ;;..'{. qp
$ 5.00
$
$
$
$
$
TOTAL DUE
Permit Fee
Park Support Fee
SAC
Plan Check Fee
Water Meter Size 5/8"; 1";
Pressure Reducer
State Surcharge
Penalty
Plumbing Permit Fee 6'tf;t-~
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
~;:ti:~dm. p,_ :~AP~'"
"" '10m, Om,i,' 'l/'t/:""
S~/ q;;
)('J()I'f:
Paid
Date
# $
# $
$
$
# $
# $
$
$
$~Zf).qr
Receipt No.,6' ud
By c(
0--
ThIS IS to eerl1fy 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 constItutes a temporary Certificate of Zoning compl1ance and allows construcl1on to commence. Before occupancy, a Cerl1fieate of Occupancy must be
issued
Planning Director
Date
24 hour uotice 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
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ~ 7 S ty/1JTlvtf/) 0 C-/~
NATURE OF WORK A~ I u/V7-Tl () J
USE OF BUILDING _ /20' n/ /e-
PERMIT NO. or: (J 7(; 9 DATE ISSUED 8 - 2- 2, oS-
CONTRACTOR pOf5sEk-/ HC/I//IIeW PHONE 4-45".84.39
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR ,
~
DA.TE I
r//o /oy
FRAMING
INSULATION
ELECTRICAL
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1iI~tJM_d._ - -'~
HEATING (if required)
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
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BUILDING
ELECTRICAL
c:~_ -
HEATING
DO NOT OCCUpy
y~
,
j/~ //b~r
UNTIL ABOVE HAS BEEN SIGNED
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.
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
367S- &JJtA./()O I
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~~NSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~FINAL
COMMENTS:
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DATE TIME
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o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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~ORK SA TISF~", reR~ DRnr~~""
~'ORRECT ACTION AN~ PROCEED
o CORRECT WOY<j?-~ REINSPECTION BEFORE COVERING
Inspector: ~~ Owner/Contr:
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY!