HomeMy WebLinkAboutBldg Permit 04-1208
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERIUICATE OF ZONING COMPLIANCE..
AND UTILITY CONNECTION PERMIT
I. Wh.. Fil.
2. Pink City
) Yellow Applicant
(Please tnJe or print and sip at I . .,....)
ADDRESS 11
'-I,~'J'J l 'A1~LZt ~ JE-
LEGAL DESCRIPTION (office use only)
LOT / I BLOCK ~ ADDITION ~U /f-~c r-~ t.A;.-f
~
OWNER
(Name)
1,tV\ r.ht'Y'\ 'uJ IQ (~)SI<...'1
I./:!/JQ. - (I reSI-rh~ *- ~ p
/LJ8....
(Phone) 96~' l.f{)_~.. Obi"
(Address)
Date Rec' d
/2. tv.. 04--
I PERMIT NO.04. IZOe;
ZONING (office use)
K./
PID Zo.:?/~. 0/1. 0
BUILDER ~ S>' ~
(Company Name "toY\.. i~'1 j -LN:... . (Phone) bSl . CIS? .C;O/O
(Contact Name) I i ('...h.o..rrl ~IO ^ (Phone)
(Address)~f./55 c..~; p Aoe. '-1' ~l.>~G.,.o~ Hco-tS..- mttJ <SO~
TYPE OF WORK 0 New Construction ODeck OPorch ORe. Roofing )tRe.Siding DLower Leyel Fimsh 0 Fireplace
DAddition ~lteratiOn OUtility Connection 0 Misc.
CODE: OI.R.C. OI..B.C. PROJECT COST/VALUE S ~~..cO
Type of Constn1ction: I n m IV V A B (excluding land)
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
I hlTeby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owncr ur authorlzcd agcnt for thl'r
above-mentioned r"wr'..J and that aU construction will conform to all existing state and local laws and will proceed in accordance with submilled plans. I am aware that the building
~por~re.lhereby agreethattheci~~a2;Q3;~~i~ r--r-") topmorm necdl/~~8 'OL/
Signature Contractor's License No. Date' .
Permit Valuation
Permit Fee S
Plan Check Fee S
State Surcharge S
Penalty $
Plumbing Permit Fee S
Mechanical Permit Fee S
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
I Park Support Fee
SAC
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTALDUE
Paid / "" (/V
Date 1'1,. . (/7 . () 4--
,
ThIs Application Becomes Your Buildinl Pennit When Approve.
Building Official
Date
# $
# S
$
$
# $
# $
$
$
$ ~~. f/l)
f
I Recei1!:,o. ,.81b rt-
I BV ~ _
0
TIus IS to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may ...w...1I as requl'Stcd. This ducument
when signl'd by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Ccniflcate of Occupancy must be
ISSued
PIannina Director
Date Special CondiliOllJ. if my
24 hour notice for alllnspectionl (9~2) 447.98~. fax (~2) 447-424!1
16200 Eagle Creek Avenue Prior Lake. MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
~~ ?J: Q~VU-Jr-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
P INSULATJQ~ 0 SEWER HOOKUP
~FINAL '::),. 0 PLUMBING FINAL
o SITE INSPECTIO r MECH FINAL
COMMENTS: (). .
DATE nilE
Irz~~r
cj - / /"( ct!J
o EXIGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORREC~! f1'<. CALL FOR REINSPECTION BEFORE COVERING
Inspector: i I / Owner/Contr:
CALL 7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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