HomeMy WebLinkAboutBldg Permit 04-0887
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERH~.CATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
r;, l 0 1-
I. White File I PERMIT NO
2. Pink City . iI +. 0 I' 1/1 7
3 Y cllow Applicant f/ /I
(Please type or print and sip at bottom)
ADDRESS
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(2i,
LOT
BLOCK
LEGAL DESCRIr uON (office use only)
ADDITION
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OWNER
(Name)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
Uv-
(Phone)
(Phone)
ZONING (office use)
PID ZS. z..1'Z. . 004- . ()
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~
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TYPE OF WORK 0 New Construction DDeck DPorch ~-ROofing D~e-Siding DLower Level Finish 0 Fireplace
DAddition DAlteration OUtility Conne~'" 0 Misc.
CODE: OJ.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
J
E
IT
F
I
B
S U
PROJECT COST/VALUE $
(excluding land)
ill IV V A
HIM R
2 3 4 5
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 authonzed agent for the
above-menttoned 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 revoke trr ~herebY agree that theca;;1 a ~i;;rna?er upon the procr tor??ad~spections.
Signature Contractor's License No. Date
I Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter SizeS/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
This Application Becomes Your Building Pennit When A.. ." ,cd
I Paid
I Date
-
'Ill ,(IV
f-!- d4--'
Building Otlicial
Date
# $
# $
$
$
# $
# $
$
$
--
$ /C,. W
r) ~
ReceiJ:t )4' o. 4f1.;7 7 r -Z-
By J/'
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 S5372
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
J/9 S ~~/h~.,L
OWNER
CONTR.
PHONE NO.
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
COMMENTS:
/J /)
~~/OO r
DATE nilE
~~~-
Ci-
#- f7Y7
o EXIGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
o
.-? ~ /J
~//e ~
,
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~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT wo~...:. ~A~L:J>R REINSPECTION BEFORE COVERING
Inspector: 7~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYI