HomeMy WebLinkAboutBldg Permit 04-1087
(Please me or print and sign at bottom)
ADDRESS
Z77~
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
10 ,;).0.0 ~
~. ~i~~e ~:;y I PERMIT NO. AA.... I () B7
3 Yellow Applicant u-r-
~/WC- ~
LOT
BLOCK
LEGAL DESCRir uON (office use only)
ADDITION
PID "Z--r. / j> ../. 0 / d.. I
OWNER
(Name)
(Address)
(Phone)
BUILDER C .LJ
(Company Name) , " .
(Contact Name) ~6 H i\J
(Address) zq 7 ~ C .....,,\'+~ ~
ZONING (office use)
tel..f!J
C (j fL tr-~ fo('.s
(Phone) I (pi Z) Ltc"O - Z I a C(
(Phone)
i&.
l
TYPE OF WORK 0 New Construction ODeck o Porch ORe-Roofing Tv'Re-Siding DLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection 0 Misc.r
CODE: OJ.R.C. OJ.B.C.
Type of Construction:
Occupancy Group: A B
Division:
J
E
PROJECT COST IV 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
rty and that aU construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
ermit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed Inspections.
X ,/V ~ /0-20 -Q 4
~;ture Contractor's License No. Date
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 Permit Fee
II
F
I
m IV V A
H J M R
2 3 4 5
B
S U
$
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
#
#
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
7v.(/O
/0, 2--1. () ~
Receil}1ft~7 g9&
By I L..
Building Otlicial
Date
$
$
$
$
$
$
$
$
$ 7'.00
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
SCHEDULED
ADDRESS ~97b Gh-h,.-
OWNER CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
ArFINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
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~.s/ de
~ / /
(o~ / /c:;.. 'Te-
/
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-----
-
DATE nME
'-?ft~S-
GJL/- /oJ>'/
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~
)
~
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr.
- ~
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI