HomeMy WebLinkAboutBldg Permit 04-1089
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File I PERMIT NO I c4
~. ~:~I~W ~;~Iic.nt otJLj - / tJd I
(Please type or print and sip at bottom)
ADDRESS ZONING (office use)
; ll{7 ~ fr<U.e~ W', ~ tJ
LEGAL DESCRIPTION (0,"" ore 001,) Q <
LOTO BLOCK G ADDITION ~~ f!t.fh
OWNER
(Name)
!fir e 5 CR- ee:r ~C0 f)
<fA, .A
(Address)
BUILDER ( II
(Company Name) e..L tt
(Contact Name) (jf.L{ j
(Address) 41rf?~t4Lcrl'.9J('
PIDd$-n;;.. -m~-d
(Phone) q (?.. 2.. ~ ~~ '3.,\
(Phone) 4i~~O%
(Phone)4!l2. :J.. ~ (J 7~
fJ-l/c;J ~L;(A;( faJ'K .t?111 ~~ Iv
TYPE OF WORK 0 New Construction DDeck o Porch ~e-Roofing ORe-Siding
o Addition o Alteration OUtility Connection 0 Misc.
CODE: OI.R.C. OI.B.C.
Type of Constnlction:
Occupancy Group:
Division:
A
B
I
E
llIIV
H I
2 3
V
M
4
DLower Level Finish
o Fireplace
A
R
5
PROJECT COST /V ALUE
(excluding land)
$ ~'~O 0
I hereby certify that I have ti.tmished 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
;~~ebY agree that the city officialZit;:6e may enter upon the property to perform nee;;;:;;;:q
(/ Signature -- Contractor's License No. Date '
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
IT
F
I
c;z SaD.. 00
$ 7'/, 15
$ J,..8~
$
$
$
$
$
$
This Application Becomes Your Building Pennit When A.. .. ,ed
Building Otlicial
Date
B
S U
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
~/ t;, -- _ , I
/0 -JO 0/
I Paid
I Date
# $
# $
$
$
# $
# $
$
$
$ 74,. ~~)
Receipt No.i76{)tJ/
By Y
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 consl1tutes 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
DATE TIllE
CITY OF PRIOR LAKE
INSPECnON NOTICE
SCHEDULED
ADDRESS
...?2P? S/)rtVce 7//
/ CONTR.
PERMIT NO. ~~- /On
OWNER
PHONE NO.
.......~,-
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
4-f11NAL 0 PLUMBING FINAL
o SITE INSPECTION j~ MECH F1N;t1.
COMMENTS: /~ rClO
j~ /' / /
~ce~ 7~O .t:7/c: TPyeS
-_ Tr>~ ~~ ~;,~rec-?46~"
~ ...$4&1~ ,2 Y~~.s
~ ~{..J...('" .p -
./
~
/
o EXlGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
/
/'Cy,/t
~WORKSATISFACTORYIPROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, ~~I}~~SPECTION BEFORE COVERING
Inspector: /~ OwnerlContr.
CALL 447.8850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &; SAFETY/
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