HomeMy WebLinkAboutBldg Permit 04-0979
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERl uICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3 Yellow Applicant
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LEGAL DESCRIPTION (office use only)
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LOT I Z-BLOCK I ADDITION
OWNER
(Name)
(Address)
(Phone)
BUILDER /J /J
(Company Name) {- J ~"A"#,".:lu~
(Contact Name) (lu~1 fek/'Y~
(Address) '1/.,00. s-o#r ~f J1/ i/&./
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Date Rec' d
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I PERMIT NO. 0+,0 97'1
I
ZONING (office use)
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PID zs: z,.t'1'. OlZ,.. 0
(Phone) ~k-- 7,,, - ?Sqy
(Phone)
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OLower Level Finish
o Fireplace
B
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B
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PROJECT COST IV ALUE $
(excluding land)
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IDlY
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2 3
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M
4
A
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5
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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 aU construction wiIl conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
off1cial can revoke this p mit for just cau rmore, I hereby agree that the city off1cial or a designee may enter upon the property to perform needed Inspections.
2/\ '1'1~O /7
Contractor's License No.
I
TYPE OF WORK 0 New Construction ODeck o Porch }(Re-Roofing ORe-Siding
OAddition OAlteration OUtility Connt:ttolt 0 Misc.
CODE: OI.R.C. OI.B.C.
Type of Construction:
(~pancy Group:
, ision:
,
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
Signature
$
$
$
$
$
$
$
$
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Pennit When Approved
I Paid
Date
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Building allicial
~
Date
~-.4~ ~y
Date
# $
# $
$
$
# $
# $
$
$
$ 7".O(}
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Receipt e.
By , ..
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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
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
~d
Planning Director
Date ~ ~
24 hour notice for all inspectio~i)52) 447-9850';><<x (952) 447-4245
16200 Eagle Creek Avenue }>nor Lak~, MN 55372
Special Conditions. if any
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CONTR.
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
[] FOUNDATION
o FRAMING
o INSULATION
)i"FINAL
o SITE INSPECTION
COMMENTS:
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/L4r~D T
SCHEDULED
PERMIT NO.
o PLUMBING RI
[] MECH RJ
[] WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
[] MECH FINAL
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DATE TIME
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o EXIGRADlFILLING
o COMPLAINT
[] FIREPLACE RJ
o FIREPLACE FINAL
o GAS LINE AIR TST
[]
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~WORKSAT~
o CORRECT ACTION AND PROCEED
[] CORRECT ~~J;roR ~EINSPECTION BEFORE COVERING
Inspector: ~ p-- Owner/Contr:
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH & SAFETYI
IN8NOTl