HomeMy WebLinkAboutBldg Permit 05-1073
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERl uICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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(Please type or print and sign at bottom)
ADDRESS
I. While File I PERMIT NO s: I
i ~:~~w ~::Iicant . 0 . / () 73
5HO
P~K-J tU~
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT 6BLOCK Z ADDITION L!/ZoVP t/~ ;t./7U-<1' ~
pm 25-.02-1. 0/1. 0
OWNER
(Name) Q\.ltB~ t:u=c:: ~..
(Phone)
(Address)
5440 ~~ ClJ? f' \-E.- "5..E
BUILDER
(Company Name)
(Contact Name)
(Address)
A - \~ A)--i. 2~Hl'\~L1 ut__
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(Phone) ~\"2.-q(.....~-q \Sb
(Phone) ~A.\-te.
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TYPE OF WORK 0 New Construction .L\ifr>lck o Porch ORe-Roofing
OAddition OAlter~o~ OUtility Connection
CODE: iJJI.R.C. DI.B.c. 0 Misc.
Type of &nstruction: I II ill IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
ORe-Siding OLower Level Finish
o Fireplace
PROJECT COST /V ALUE $
(excluding land)
I hereby certifY that I have lilmished information on this application which is to the best of my knowledge true and correct. I also celtify that I am the owner or authonzed agent for the
above-mentIOned p~ perty and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
()tf~_...,. c pe It Just cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed Inspections.
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Signature
L04 <;::\~ L7-.-\
Contractor's License No.
to - 2b - "2./."",~
Date
I Permit Valuation -'000 , 00 I Park Support Fee # $
I Permit Fee $ If /. z,$'" I SAC # $
I Plan Check Fee $ Z~. ~ I I Water Meter Size 5/8"; 1"; $
I State Surcharge $ , S"o I Pressure Reducer $
I Penalty $ I Sewer/Water Connection Fee # $
I Plumbing Permit Fee $ I Water Tower Fee # $
I Mechanical Permit Fee $ I Builder's Deposit $
I Sewer & Water Permit Fee $ I Other $
I Gas Fireplace Permit Fee $ I TOTAL DUE ~/4.Z,'.DS- $ t-g, SC-
. /7
This Application Becomes Your Building Permit When A~~." I ed I Paid 'J:~kJ R;!iJ1fNO. 6lJ~ .r
~ ~I-} M't..fJ lor I Date I; ,JI. 'r B.,.
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Buildilll! OtliCi:ll Date
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 constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Cel1ificate of Occupancy must be
issued
Planning Director
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
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PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 5#0 ~~Iz)~J' &/t/~
TYPE OF WORK LJt;.7!-IC.
USE OF BUILDING RG7 $"-
PERMIT NO. tJ5. /073 DATE ISSUED /11.
BUILDER /1. / ~ PHONE # (;f"Z. 9(,8. 9~~?;
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR ~ DATE
I FOOTING I ~ I //h~r
,
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNE.D
I I
J FINAL
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FOR ALL INSPECTIONS (952) 447-9850
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CllY OF PRIOR LAKE
INSPECTION NOTICE
DATE nilE
ADDRESS
SYYO ~oo4
IP~AJ
C~
SCHEDULED
OWNER
CONTR.
PHONE NO.
PERMIT NO.
[] FOOTING
[] FOUNDATION
[] FRAMING
[J ~ULATION
~INAL
[] SITE INSPECTION
[] PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
[] PLUMBING FINAL
[] ~FINAL/
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COMMENTS:
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASUNE AIR TST
[]
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V/iJS--e
~RKSATISFA~=E=S
[] CORRECT ACTION AND PROCEED
[] CORRECT WOR~'~;;7R REINSPECTION BEFORE COVERING
Inspector: Y#7 ~ Owner/Contr:
~
CALL 447-9850 FOR THE NEXT INSPECnON 24 HOURS IN ADVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/