HomeMy WebLinkAboutBldg Permit 05-0941
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and si!!:n at b___.ou)
ADDRESS
1-287 G;f'A/NWcrvO
LEGAL DESCRIPTION (office use only)
LOT!~ BLOCK
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. Os-.. (; 9+/
e-/~ ,ue
ADDITION 6/?#NWrlJ 0 r~c....
PID zs-. o3J_ C)I Z _ ~
OWNER
(Name)
LlZ~",
k",,,............
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
Date Rec' d
9: oz,Z--. 0':;;
ZONING (office use)
IeJ.f LJ
(Phone)
~3S-- ~l~
~ ~S C'1.. ~l) t,- ct D t'\. <;. 4-.
'J 0 kif'\. LC\....Sc.L.., ~lJ-c...
G Ne" l..\..~lt~ ~
(Phone) c.., f J.. ... c<4D - -, I 0 '0
(Phone)
'~~ILf
ll' \.
TYPE OF WORK 0 New Construction ~eck o Porch ORe-Roofing
OAddition OAlteration OUtility Connection
CODE: DI.R.c. DI.B.c.
Type of Construction:
Occupancy Group:
Division:
III IV
H I
2 3
V
M
4
I
E
II
F
I
A
B
ORe-Siding
OLower Level Finish
A
R
5
o Misc.kfll:.l..c.e.- Dec.k..
PROJECT COST/VALUE $
(excluding land)
o Fireplace
I~~
,
[ hereby certifY that [ have furnished mformation on this application which is to the best of my knowledge true and correct. I also certifY that I am the owner or authorIzed agent for the
above-mentIOned property and that all construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official can revoke this per~t for Just cause Furthermore, I hereby agree that the City official or a designee may enter upon the property to perform needed l,nspectlOns
, .
X a~~ ('..,~~........._- Lf~'S'1 ~-~~-D"-
i - - Signarure - - Contractor's License No. Date
Permit Valuation /,WO
Permit Fee $ (,7 J...r
Plan Check Fee $ 4 1 '/
State Surcharge $ elf)
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
::J1tif/r' Y:~B"'m. p~ ;;:;,.
8uJill~mCial Date
$
$
$
$
$
$
$
$
? -e" - 05" $ (LlLI. 8""
~e;f:t No. #91S"
U
B
S U
Park Support Fee
SAC
#
#
ThIS IS 10 certilY that the request 10 the above applical10n 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 compliance and allows construction to commence. Before occupancy, a Certificate <If Occupancy must be
issued
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
,. I
1'1 Wi-
Planning Director
e. }Cq(",+ I4d,,~
Date . Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Water Tower Fee
Builder's Deposit
Other
#
TOTAL DUE t!4LfaL
Paid III. 9(P
Date 'l.Z1.Os
~
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS &fu-J ~'" cullt'Jd
TYPE OF WORK De"" Lc ""'~"T
USE OF BUILDING S. F- ('.J.
PERMIT NO. (J5. 094-/ DATE ISSUED
BUILDER use,..",. <:....,.". PHONE # f.U -,..- ,,.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
FOOTING I ~ I /ORe>/oS-
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
~ I I
FINAL
. _ /J
\/VV/
I (r1~
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
1/, 7-c"/;;) -
ADDRESS
LJJ..k'7 (j..q"" ../~ c;...
OWNER
CONTR.
PHONE NO.
PERMIT NO.
.s: fe-( f
o FOOTING
o FOUNDATION
o FRAMING
o INSULA TION() r(
Jii"FlNAL '( C-
D SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
(
"',
/1
( /( O~>
" -..
">.~ ~
'I )
r!~ /
, /
~
---
--,.'
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/WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PR CEEO
o CORRECT WORK, C L 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!
lNSIfon