HomeMy WebLinkAboutBldg Permit 04-0994
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yellow Applicant
PERMIT NO. Of-. Oqf~1
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ADDRES5-ttJ B (/ t!ldaL/Q1:Jd7fL PtIOr la1u-
LEGAL DESCRIPTION (office use only)
LOT 7 BLOCK I
ADDITION S/lNO PtI/1l/7 ..3~
-
PID zS. 2/4-. 007. 0
&':~R -' )onm fJ.J/XJdS
(Address) S~ ~~
I BUILDER I r. J? LlD~~' A/'I'
(Name) 1--" (..) ,. /,-, {\IV ~ U!UJ
(Contact Name) ~l1.rL. - ~- ~
(Address) //r~ POIA)I- [}JUS/af DrJO.
Date Rec' d
'1_ :3 0.04-
ZONING (office use)
PtJLJ
(Phone)
Cf5 Q. <fI(P - OLqtj:?
(Phone) 05/ ~cP-08l/'1
(Phone)
Ihsfirtf <JrIIt ~ SSa3 ~
OPorch ORe-Roofing ~e-Siding
/1
ave furnished information on is application which is to the best of my knowledge true and correct. I also certifY that I am the owner or
authorized agent fi e above-mentioned y.uy.... d that all construction will conform to all existing state and local laws and will proceed in accordance with
,ubmined ''-roW;: .... th . .. · u .,:' om :UIre .....- 'n< ju>t "'~';WI b<reby '''''' th" .c}'"J-j M .",
/ Signature Contractor's License No. Date'
{ pe~~aluation III a f]./ I
l-1""ermit Fee $' JlO'/
I Plan Check Fee $ l
I State Surcharge $
I Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
TYPE OF WORK
o New Construction
ODeck
OLower Level Finish
o Fireplace
OAddition
OAlteration
o Misc.
PROJECT COST IV ALUE (excluding land) $
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I City SAC and WAC
Water Tower Fee
#
#
#
#
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
'7{'. () 0
/o./. () 4-'
Recei~ 4-7 IJ+7
B,(IIfIU ,
Paid
Date
Building Official
Date
OUtility Connection
$
$
$
$
$
$
$
$
$ ?(,.tllJ
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,..,..yu...ry 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 TIME
Jh/hf-
, ,
~~'LvCO/
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
~y
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
[] FOUNDATION
o FRAMING
[] INSULATION
At"'FINAL
[] SITE INSPECTION
o PLUMBING RI
[] MECH RI
[] WATER HOOKUP
[] SEWER HOOKUP
[] PLUMBING FINAL
[] MECH FINAL
COMMENTS:
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o EXIGRADIFILLING
[] COMPLAINT
o FIREPLACE RI
[] FIREPLACE FINAL
[] GASLlNE AIR TST
[]
~
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~
\
%WORK SATISFACTORY, PROCEED
[] CORRECT ACTION AND PROCEED
[] CORRECT ~R~ ;~OR REINSPECTION BEFORE COVERING
Inspector: _/~r- Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .I SAFETYI
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