HomeMy WebLinkAboutBldg Permit 04-0912
~.
I
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERIUICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and si<<n at bottom)
ADDRESS
1,311 :s~+--r; SIN
Date Rec' d
J. White File I PERMIT NO
2. Pink City .
3 Yellow Applicant
Prr~r ~k
LEGAL DESCRIPTION (office use only)
LOT8~LOCK ( ADDITION{L:btrlU~ k-1-
OWNER
(Name)
(l1 i J".\1J \kt1Ju;ltt:A{(
173J/ S~Y1s.t.-t- w SIN
(Address)
BUILDER I\IJ I I t / i )
(Company Name)-----1I.1i..t.J Vot1l1..WlllA V/'"
(Contact Name)
(Address)
"~ If Sk Vl ~ -I- ---r? 5 vJ
(Phone)
Pri c.r /";'/Ce.
(!)tI-9/~
ZONING (office use)
PIna,5' 185 -tJB~-?J
95;;'" WlJ- 'If:)-5
(Phone) 'J5) - 9Qt'... ~S
(Phone)
TYPE OF WORK 0 New Construction ODeck o Porch btRe-Roofing ORe-Siding
o Addition OAlteration OUtility Conne/ion 0 Misc.
CODE: OI.R.C. OI.B.C.
Type of Constmction:
Occupancy Group: A B
Division:
I
E
II
F
1
ill IV V A
HIM R
2 3 4 5
OLower Level Finish
o 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 authOrized agcnt for the
above-menl1oned 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%" 24'st caus ,Furt re, I hereby agree that the city official or a designee may enter upon the property to perform needed ~~ct:;1~OY
. 'l Signature Contractor's License No. Date
,
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
dsco--- .
$ 7t1# 75'
$ )'~6
$
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
Building Otlicial
Date
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
7(,. D (J
1. 1t1~ #I-
Paid
Date
# $
# $
$
$
# $
# $
$
$
$ 7" .--
ReceiPt Ii6. ~7~
By 'L ' ~,
cJ
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
l6200 Eagle Creek Avenue Prior Lake, MN 55372
---"'-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIUE
"Jhh~-
- ,
ADDRESS
/ /U// ~\~~el
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
A--FlNAL
o SITE INSPECTION
COMMENTS:
// /)
.J:-c/tJor
CONTR.
PERMIT NO.
o/9/~
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADJFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
./? / I
&~/J/~ t<-
/
,.------.. ----.....~
~/ /'/ )
fLtore- ~ Ie ./
~WoRKSAT~Ry.PR~
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 &: SAFETY!
INSIfOn