HomeMy WebLinkAboutBldg Permit 04-1164 - roof
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ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I, White File
2. Pink Cily
3 Yellow Appliean'
Date Rec' d
/ I; 1S'~04-
PERMIT NO. ()+.//(,<'
/~549 .sf/O/2& W.
LEGAL DESCRIPTION (office use only)
LOT 3 BLOCK 7
OWNER
(Name)
J l1f'M 11
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(Address)
ADDITION
S/JN.o
PT.
PID zj.21b. d 17. ()
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ZONING (office use)
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(Phone)
tI S~ - t.j '-15'. 5" If('
BUILDER
(Company Name)
(Contact Name)
(Address)
TYPE OF WORK 0 New Construction DDeck DPorch v1Re-ROOfing ORe-Siding DLower Level Finish 0 Fireplace
o Addition OAlteration OUtility con~~ 0 Misc.
CODE: DI.R.C. DI.B.c. PROJECT COST/VALUE $
Type of ConstIUction:' I II ill IV V A B (excluding land)
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
(Phone)
(Phone)
I hereby 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 owner or authorized agent for the
above-mentioned roperty 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
;cial can r thIS per"l!! for JuOs~e,_ I hereby agree that the City offiCial or a deSignee may enter upon the ,,'V,,",] to perform n~~nuctli$ 2 t:JC.Jc/-
( - Signature Contractor's License No. 'Datel
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Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
Park Support Fee
#
$
$
$
$
$
$
$
$
SAC
#
Water Meter
Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
This Application Becomes Your Building Pennit When A. . .." I' ed
Paid
Date
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/)
ReietPt No.
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Buildinl! Otlicial
Date
$
$
$
$
$
$
$
$
$
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,
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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
Date Special Conditions. if any
24 hour n~tice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
DATE
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
[] FOOTING [] PLUMBING RI
[] FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION [] SEWER HOOKUP
~ [] PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: ~ /J
Le /o~ r
TIME
t:;~ //b 0/
"
[] EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
[] FIREPLACE FINAL
o GASLlNE AIR TST
[]
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~K SATISFACTORY, PROCEED
~ '~~~RECT ACTION AND PROCEED
[] CORRECT WOR;~EINSPECTION BEFORE COVERING
Inspedor: 'V- ~ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSIIOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI