HomeMy WebLinkAboutBldg Permit 04-1128
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please tvve or print and sip at bottom)
ADDRESS L::
3-/ II
I. White File
2, Pink City
3 Yellow Applicant
nRIlJH .1/.
LEGAL DESCRIPTION (office use only)
LOT I BLOCK 2.- ADDITION
OWNER
(Name)
o A-/Lt(
3111
(Address)
J-fL.. tI IetJ flY'
1);1-11 L (0 a c-
J'V. ~. 0Al'l<) // sf'
(Phone)
Date Rec' d
Il 2,.# ~+-
PERMIT NO. (J'ff" IlL 8
ZONING (office use)
,eN'" 0
PID t..s-. /(,0. ()fJ5. ()
t; i,f) " &? 5f j J
~~~~~Name) C-fl1-,~k1- :511:l11'?<-~ f 1~~L//t '/ {:;:;) ~a. -.; ?9 _ /,,~ ~ J
.. c r~~
(Contact Name) -3J ~1f-/l-.tL ! /7/ I, 1~-1/ (Phone)
(Address) '-21 c7 1:i-J' C 1:1 vt-- D o.:J 0/-145 k ~
(J/) I t/;C
- J
TYPE OF WORK 0 New Construction ODeck o Porch ORe-Roofing lafne-siding
o Addition OAlteration OUtility Connection 0 Misc. IV'
CODE: OI.R.C. OJ.B.C.
Type of Constnlction:
Occupancy Group: A B
Division:
OLower Level Finish
o Fireplace
J
E
II
F
I
B
S U
PROJECT COST IV ALUE $
(excluding land)
/'1, Db?)
/
ill IV V A
H J M R
2 3 4 5
/"'I
in~ ation 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-me IOned properry a t a onstf\lctio will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
X . I can e~s ~r; for J caus u ermo I hereby agree that the city official or a Zi JY ~er upon the properry to perform needed ;~Zs'/.2. Cli>$f-
. / Signature tontractor's License No. f DatE
v-
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
, Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
'7f1 .flU
/1~_I4--
Building Otlicial
Date
# $
# $
P
$
# $
# $
$
$
J1/$ 7(,.0 ()
IJ fl"JU--
R:;tNO
By" .
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 notiee for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
0-/./ nUE
fLYttl-
SCHEDULED
ADDRESS
J?// ~QL
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~//,2r
a FOOTING
o FOUNDATION
o FRAMING
o INSULATION
piNAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILUNG
o COMPlAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
COMMENTS:
/J . /
/C<5/de
......-, 7 /
(a~/::?/e/-~
/
r:z ..)..e
---~ ')
A/JO
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, ~~L~7 ~EINSPECTION BEFORE COVERING
Inspector: _ ~ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
_Tl
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