HomeMy WebLinkAboutBldg Permit 04-1112
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please tv1Je or print and sip at bottom)
ADDRESS
I S6SJ
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LEGAL DESCRIPTION (office use only)
LOT $ BLOCK / ADDITION
OWNER
(Name)
~
Peu,vert7
(Address)
I~S-J
BUILDER
(Company Name)
(Contact Name)
(Address)
I. White File
2. Pink City
3 Yellow Applicant
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(Phone)
Date Rec' d
PERMIT NO'&LI- /I/~
ZONING (office use)
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PID ;;;2L)- 3c73-00 3-Q
(Phone) ~. $;1,'?;! -.~.:1~o
(Phone) ~-J1T.2- 7;10"
TYPE OF WORK 0 New Construction DDeck o Porch ORe-Roofing ~e-Siding OLower Level Finish 0 Fireplace
DAddition OAlteration OUtility Connection 0 Misc.
CODE: DI.R.C. OI.B.C.
Type of Constnlction:
Occupancy Group: A B
Division:
I
E
II
F
I
ill IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST /V ALUE $
(excluding land)
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 property 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
official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed Inspections.
X ~e Contractor's License No, IO/t:re7./oV
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace P~rmit Fee
~ I / /
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, I
"2.--=) c.:t ~ _-
$
$
$
$
$
$
$
$
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I. 1-.)-1
I
I
I
/
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
Builder's Deposit
Other
I TOTAL DUE
I Paid ' ,(,. ---
I Date
# $
# $
$
$
# $
# $
$
$
$
..., (p - -
~ 80 (!) b'"
~
f-
Receipt No.
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 notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
,.
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ISo.~ 1
OWNER
PHONE NO.
o FOOTING
D FOUNDATION
o FRAMING
o INSULATION
)(FINAL
o SITE INSPECTION
COMMENTS:
1?~
SCHEDULED ~ J <.,
UW~~
CONTR.
TIME
PERMIT NO.
l/ -III '--
o PLUMBING RI
D MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADlFILUNG
D COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
- .-
~~
~ 41in
~K SATISFACTORY, PROCEED
D CORRECT ACTION AND PROCEED
o CORREPlRK' CALL FOR REINSPECTION BEFORE COVERING
Inspector: 'h Owner/Contr:
~Al!. J;Jo FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOn