HomeMy WebLinkAboutBldg Permit 04-1243
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
t.IDtO
(Please type or print and siRJ1 at bottom)
ADDRESS
Date Rec' d
/2. 22,~4-
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 01-'/24-3
/5Z5~ WOOL) O(/~ 77V'1/L
LEGAL DESCRIPTION (office use only)
LOT 9 BLOCK Z. ADDITION
OWNER
(N ame)
IV/L-OS sov7H
M /&/s 9 t/t..,lJ eK.soAl
6J.5"~ LJrJoJ Ov..c Ie- ''-/ AJ~
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
ZONING (office use)
1</
PIDZS: 382.052.0
c; ~;) - Xlb - .k3',3
(Phone)
I> r-,(, r- Le. k.A-
(Phone)
(Phone)
B
S U
)(Lower Level Finish
4- ~.s.
PROJECT COST /V ALUE $
(excluding land)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding
DAddition OAlteration OUtility Connection 0 Misc.
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group:
Division:
A
B
I
E
II
F
I
V
M
4
A
R
5
o Fireplace
I hereby certifY that I have ti.1rnished information on this application which is to the best of my knowledge true and correct. I also certifY that I am the owner or authonzed agent for the
above-menuoned properry 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 building
otfIcial can revoke this permit for Just cause Furthermore. I hereby agree that the Clry official or a designee may enter upon the property to perform needed mspectlOns.
X C).;(.,~ /1-/7- of
Signature Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
'$
III IV
H I
2 3
4, 0 a o. 0 0
PJ7.2S
2-.00
40.00
I
. ~ .-/\
Bui ding Otlicial"",," I
'--/
4-0.00
~1:t"
Data'
Park Support Fee
SAC
l
#
#
$
$
$
$
$ I
: /'~
$ /. () 0
$ /~O_ zsl
Paid /70.2S
Date / Z, 2- Z. 0 of--
ReceipJ: No. '1-8(P/L
BY;um
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other &t-6(7}e/ e"fi L-
TOTAL DUE
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 Certificate of Occupancy must be
issued
Planning Director
Special Conditions, if any
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUilDING AND INSPECTION
SITE ADDRESS /5250 wooO OU~ 7J2AIL
NATURE OF WORK L {)WEIe.. t.ev6L
USE OF BUILDING REs A/Je-
PERMIT NO. 0 4- ./24-3 DATE ISSUED /2.. Z2-~o,1
CONTRACTOR G;.1lJ.jju:::soAl PHONE 22&. 23&3
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE
'GAS LINE AIR TEST
f(~
e ...;C~~
-=iJ
,
M
1./?
I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
/V//as-
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
r~ 1
/
I
xt
OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
)) 1?..:1 JiJ}
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
DATE TIME
CITY OF PRIOR LAKE I '- ~d!;
INSPECTION NOTICE SCHEDULED
ADDRESS I ~ 2.5(, LJQD~ ~ \t
OWNER CONTR.
PHONE NO. PERMIT NO. 'f -lG45
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
~SULATION o SEWER HOOKUP o FIREPLACE FINAL
INAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
d>k ~ Q.l~ -I-k -fX: l ,0
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE~L FOR REINSPECTION BEFORE COVERING
Inspector: \ L..( f / Owner/Contr:
CA~tltsO FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
'oJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
/NSlIOTI