HomeMy WebLinkAboutBldg Permit 04-0931
Date Rec' d
1. I r,. Of-
I. White File PERMIT NO
1~ ~ .A+,OD3/
3. YeHow Applicant "1
(Please type or print and sign at bottom)
ADDRES5-0J-Q {&;/CJf{)JrZd it'L,
4;01" I~li?-
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT&- BLOCK +- ADDITION ~ r t ~~ " PID.t..r. ,e.14-. O'l~. 0
. ~~;~::R Pal: +'10-{ LJndoul:l" /PaJ.-L &(~1~/:;L ~ 5008
L I
(Address) SMt~ as oJy; i<.t.
. B(NUIaLmDe)ER J , J.e. A-/.J/i <' /I /) J' I /J, /1 r r I ~J / Je:O Q //1 /
^ 0 L ~ UAA...-f'~ u -...J (Phone) ftJ,.)1 'T....JO -0 l:) rY
(Contact Name) J-Ia..rlc_ P..Lizr fay-..., (Phone) I
(Address) //@X5 PoU-.bOou-rlaf t<.d f, flqJhi1y /..-I.J7 5'5033 ~ ~~dleJf
TYPE OF WORK.
o New Construction
ODeck
o Porch
ORe-Roofing
~Re-Siding
OUtility Connection
OLower Level Finish
o Fireplace OAddition OAlteration
PROJECT COST IV ALUE (excluding land) $ /9 J ()()O
o Misc.
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 above-mentioned property and at all construction will conform to all existing state and local laws and . .~~__j :'1-lI.Ccordance with
submitted plans. I a aware that the building offici revoke tliis pel or just cause. Furthermore, I hereby agree e city official or a designee may
;ter upon the pro to perfo InID '0 . __.... - / '18~ 1- '1- o'tf \
,// / s......,./ /' Ie""""",,, Lirem< No. ( D.t<)
I Perinit~luation . / ... . / 0 (j f 109... Jark Support Fee \ # $ /
If~tFee / $ t-l O~l _)I /, 'I~) SAC ~ $ /
I :Plan Check Fee I $ ~ -tJ /\ ~ J I I WaterMeter Size 5/8"; I"; ---- It ~
I State Surcharge $' .J' I Pressure Reducer $
I Penalty I $ / I City SAC and WAC # $
I Plumbing Permit Fee ~ $ ../ I Water Tower Fee # $
Mechanical Permit Fee $./ I Builder's Deposit $
Sewer & Water Permit Fee.J,./" I Other $
I Gas Fireplace Permit Fee $ I TOTAL DUE $ ? 5:- () 0
This Application Becomes Your Building Permit When Approved
I Paid
I Date
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I Rece~o.
IBV 0
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Building Official
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, tax (~52) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE nME
J#J~
, ,
ADDRESS
~;Z? r:,t;r~1
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
p.-t=INAL
o SITE INSPECTION
COMMENTS:
/J /
/L-6!JIde
/
( :2..-1
V ~tb-Se.
"---.
CONTR.
PERMIT NO.
~9- 73/
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
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~RK 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..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETYI
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