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HomeMy WebLinkAboutBldg Permit 04-0875 CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT Date Rec' d I. White File 2. Pink City 3 Yellow Applicant I PERMIT NO.4 -f375 (Please tvoe or orint and si~ at bottom) ADDRESS ZONING (office use) tZ., ~b 3l ",-z.. L'~~N C(1l- lJ_w LEGAL DESCRtr uON (office use only) LOT S1LOCK ADDITION ?Jo/Z.rlr~ PID Zs ..tAft e>~4-o OWNER (Name) ~N5.rr-Ll.FY (Phone) (Address) BUILDER (Company Name) (Contact Name) (Address) 1& ~lJ XYf~ l!j(X)hti, krK- - lAl ~Q') tIt.)f I.ltJ ri:la /1 - - 'I q ), - -1 Y'I:l.. (Phone) (Phone) ml() 55'?S~ TYPE OF WORK 0 New Construction ODeck OPorch ~Roofing ORe-Siding DLower Level Finish 0 Fireplace OAddition DAlteration DUtiIity Connection 0 Misc. 3~&. aJ CODE: OI.R.C. OI.B.C. Type of ConstIUction: Occupancy Group: A B Division: PROJECTCOST/VALUE $ (excluding land) I E II F 1 ill IV V A HIM R 2 3 4 5 B S U I ht'feby cenil'y that I have furnished information on this application which is to the best of my knowledge trUe and correct. I also cenil'y that I am the owner or authorized agent 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 calf;;,;u;::se F~~ee that the ci~ officia~inam3/t70? property to perform need?J3dld y 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 I Mechanical Permit Fee I Sewer & Water Permit Fee I Gas Fireplace Pe it Fee I Park Support Fee I SAC I WaterMeter Size 5/8"; 1"; I Pressure Reducer I Sewer/Water Connection Fee I Water Tower Fee Builder's Deposit Other I TOTAL DUE I ~~~ lrio~f[ $ $ $ $ $ $ $ $ $ # # z,<)C!'J()., - $ ., ~,"1-S- $ $ ( .. '2--~ $ $ $ $ $ # # 7~.J - ReceiptNo:..~ By ~_- This Buil..ihl!~1 ~ -- ., ThiS IS to cenil'y that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed a$ requested. This document when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Celtificate 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 CITY OF PRIOR LAKE INSPECTION NOTICE SCHEDULED -.. rTE nilE -7~-- ADDRESS ~/6.2- .c:::;;.,/e~ OWNER CONTR. PHONE NO. PERMIT NO. ~.y- P?,-.r- o FOOTING o FOUNDATION o FRAMING o INSULATION )il'"'FlRAL 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: /J /7 /C(!rI!'JO /-. . - .-? ,,/ L.t:7~ /e rE:- -------_.~~_.._-- . / ....-J /' ( ------ ffiORK SATISFACTORY, PRU\#~~U o CORRECT ACTION AND PROCEED o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING Inspector: ~ _ Owner/Contr: ==--~ -- ~. ) (' -~S<- /? /p /' ----- -- CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI _I