HomeMy WebLinkAboutBldg Permit 04-0942
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ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERutICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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I. White File I PERMIT N
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1St-riND
ZONING (office use)
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1/ feW /€.()I=1D
LOT I BLOCK
LEGAL DESCRIPTION (office use only)
I ADDITION
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PID 25.0.8s: 001.0
OWNER
(Name)
(Address)
(Phone)
~c=:Name~...y-,ii_~""~ &
(Contact Name) ~"'.L ~ ~~, ..,-...\.
(Address) ~,,~~_~4A-_hF~U J:~
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(Phone) '6,.2- y//-~/.rs'
(Phone) tS~-S2!'/-5~~s/'
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TYPE OF WORK 0 New Construction ODeck OPorch 'tt1Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Conne~n 0 Misc.
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
III IV V A
HIM R
2 3 4 5
PROJECT COST IV ALUE $
(excluding land)
II
F
I
B
S U
x
I Permit Valuation
I Permit Fee
I Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
lication which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the
conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
rmore, I hereby agree that the city official or a designee may enter upon the property to t'".;v.... needed mspcctions.
.-?-..:2 t?...p Y
Contractor's License No. Date '
$
$
$
$
$
$
$
$
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
I Pressure Reducer $
I SewerlWater Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
I Other $
I TOTAL DUE $ '1 b. 01)
/)
Paid 7(i.() 0 Recei6tJ.r o. 1f-78.q
Date tI.~.04- 0
,
This Application Becomes Your Building Permit When Aw w.' ,ed
Building Otlicial
Date
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
ADDRESS
DATE TIME
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
OWNER
CONTR.
PHONE NO.
d- f't'"2-
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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( JJ'74 r<E-
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( c.::t () s-e
~WORKSA~~.PROC&&g
o CORRECT ACTION AND PROCEED
o CORRECT WO~:;~OR REINSPECTION BEFORE COVERING
Inspector: /~ Owner/Contr:
V
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH&: SAl'iH r/
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