HomeMy WebLinkAboutBldg Permit 04-1026
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sip at bottom)
ADDRESS
Date Rec' d
I. White File I PERMIT N ~
2 Pink City O. /1/ / -". /.
3 Yellow Applicant ( /7 . '/ {.
to. /9 t/
~-r
LEGAL DESCRIPTION (office use only) "' .
Lo/~ioCK / ADDITION ~
OWNER
(Name)
,'1:, ,-...
(Address)
fd'.. /
~
(Phone)
BUILDER /) .# / L/ I r-
(Company Name) Yr1r' r ~ (I) Qr. ~ I - C',
(Contact Name) Do - A - / /'
(Address) 70 f t? ,- A' (\ I be- /" ~ /' /":... d
TYPE OF WORK 0 New Construction ODeck ~porch ~;e-ROOfing ORe-Siding
OAddition OAlteration DUtility conn~ 0 Misc.
CODE: OI.R.C. OI.B.C.
Type of Constnlction:
Occupancy Group: A B
Division:
I
E
ill IV V A
HIM R
2 3 4 5
ZONING (office use)
PIDO? S- - O()0 - aJ/ -'0
'H7
7J</s~
(Phone)
(Phone).bl) r Jb .~ (5 '7,,2/
':J",r of&.-, ~/? 5" <3- 5:;
OLower Level Finish 0 Fireplace
B
S U
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 authonzed 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
:cial can revok25mit for just c~~ee that the ci?Cal~:71e r ~:;; property to perform nef; ;e:io;~ 04
Signature Contractor's License No. Date'
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
II
F
I
d5CJtJ,,-- I
$ /II//S- I
$ I ~ 'C}-S-
$
$
$
$
$
$
This Application Becomes Your Building Pennit When Approved
Buildinl! Otlicial
Date
I Park Support Fee
I SAC
I WaterMeter Size5/S"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTALDUE
Paid / /l.P ~
Date /0- ~-OLl
r
#
#
#
#
-
$
$
$
$
$
$
$
$
$ /(p~
Receipt No. if/~!? 7
5,
,.#
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
DATE
$--:k-
f2?~ A~J~~/
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~L
o SITE INSPECTION
COMMENTS:
/J j}
~rO() r
~
(/,Y:;e
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
[] SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
/'7 / /
UPH-f./// / e /-€-
/
----- -----.
nilE
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o EXIGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
.=--:,
..~
.'\
~ fer. ./
~
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KWORKSATlSFi,U...u.......................
/ O'cORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FO REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INS/IIOTI