HomeMy WebLinkAboutBldg Permit 04-0746
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERluICATE OF ZONING COMPLIANCE
AND lJTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
4-53S-
Date Rec' d
7. 21. I~
I White File I PERMIT NO
2. Pink City . "..11_, () 14-0
3 Yellow Applicant ~
HtJ 1'11'11 Nq 81 /U:)
~
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LEGAL DESCRIPTION (office use only)
LOT (" BLOCK z., ADDITION ,e::N od H/tA.,., 31eP
OWNER
(Name)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
M J1/ .:Jl)HI\!So AI
Lk5~tJrJ"+2-
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck o Porch 'g<Re-Roofing ORe-Siding
OAddition OAlteration OUtility Con~ 0 Misc.
CODE: OI.R.C. OLB.C.
Type of Constnlction:
Occupancy Group: A B
Division:
ZONING (office use)
Je..1
PID z.,5. 8~. 012....0
t:ts2-892-7837
DLower Level Finish
o Fireplace
I
E
II
F
1
m IV V A
HIM R
2 3 4 5
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 authollzed agent for the
above-mentioned 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
official can revoke this rmit for jus . Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed Inspections.
7- ~/-o4
x
(
Contractor's License No.
I Permit Valuation
I 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 GOO. O~
Park Support Fee
SAC
$
$
$
$
$
$
$
$
Water Meter Size 5/8"; I";
Pressure Reducer
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~ ~... ,ed
-
Paid '7 (, -("L:) _
Date ~. ,..../..# ,.-
I -
Buildil1l! Otlicial
Date
Date
# $
# $
$
$
# $
# $
$
$
$ 1'./) 0
ReceiPt;;;; , ~ Vfi/
BYe/'
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
-~-
~S3.J- a~.M/;?L~d
CITY OF PRIOR LAKE
INSPECnON NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.;IYffNAL
o SITE INSPECTION
COMMENTS:
t1 /J
~~ r/JO T
------
/ .....-, /I
( ~~-e-
'--
SCHEDULED
-
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
./7 ~ /
Lol-rl ~ / e- r-e..
/
nME
6~ -7]1t
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~
~ '\ )
/7 /e- ~
~
---
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~~ C~Ll_J?R REINSPECTION BEFORE COVERING
Inspector: ~ --- Owner/Contr.
CALL 447-9850 FOR THE NEXT INSPECnON 24 HOURS IN ADVANCE.
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH & SAFETYI
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