HomeMy WebLinkAboutBldg Permit 04-1140
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
It J~ 01-
I. White File I PERM
~. ~~~I:w ~~:Iicant IT NO. ()~. //~
(Please type or print and sian at bottom)
ADDRESS /4-tfd~ .s#fJ~ U?Al6
LEGAL DESCRIPTION (office use only)
LOT /1 BLOCK ~ ADDITION J I't?V 0 ~ 4?;!!
OWNER
(Name)
(Phone)
(Address)
ZONING (office use)
PV-CP
PID2S. 2.,S: ~ 7~. ()
BunDER l J ^ . . ~ /'l /1 0 .r 1\. C, a ~
(CompanyName)~C' t1JU5~"~""lJJ,..1 <-0. (Phone) ~d"t1'7'1 T
(ContactName)~ ~JI$F (Phone)Wa.....~?....s-~(J(!J
(Address) 311,S du 7Ll M J\J ()J C9(J(J.~ bl(, (!, I+A s I~A-- , mY. S 5 3Lf
TYPE OF WORK 0 New Construction ODeck o Porch 'klRe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility ConneAn 0 Misc.
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
B
S U
PROJECT COST IV ALUE $
(excluding land)
ill IV V A
HIM R
2 3 4 5
I
E
II
F
I
I hereby certifY that 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 authonzed agent for the
above-menl1one rop and that~ll C struction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
o . I can rev e this rmit for jIIst se Furthermore, I hereby agree that the City official or a designee may enter upon the property to perform needed Inspections.
-"~. ~11~YIJI) /,..."3....olj
- 5ignature Contractor's License No. Date
I Perm
I Permit Fee
I Plan Check Fee
State Surcharge
Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I WaterMeter SizeS/S"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
Paid 7~ ~~.
Date /E.z IJ"
This Application Becomes Your Building Permit When Approved
Building Otlicial
Date
# $
# $
$
$
# $
# $
$
$
$ '7~.OO
,
RvJ ~::J::J3
By V
"
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 constitutcs 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 notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 5S372
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
1~lf'o~ ; ~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
..,It1!iNAL
o SITE INSPECTION
COMMENTS: )
/J l
~roo I
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
Ua>-
6(-//yo
o EXIGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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VWOR~Ti'!h"","eRYI PR96E:CB
~ORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~Owner/Contr:
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CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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