HomeMy WebLinkAboutBldg Permit 04-0652
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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ADDRESS
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Date Rec' d
I. White file I PERMIT NO -1
~. ~~~~w ;~~Iicant . Otj-~5 ~
ZONING (office use)
LEGAL DESCRIPTION (office use only) iJ ~
LOTIOBLOCK 3ADDITION If/~ ~
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11" 0 1- 'L ~ A-rn IDA.. ~~...- - (!!. i tU' -
R/'V2.~l>.-l' ~. 4-
J - f) I ~ {-~~ 'r t--r,.
~ 7~~ ;;).1 _~il-L sf
TYPE OF WORK 0 New Construction ODeck OPorch II?(Re-Roofing ORe-Siding
o Addition OAlteration OUtility Conne~ 0 Misc.
('DE: OI.R.C. OI.B.C.
}e of Construction:
\'vccupancy Group:
Division:
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! hL'feby cenify that! have furnished information on his plication which is to the best of my knowledge true and correct. I also cenify that I am the owner or authonzed agent for the
above-mentIOned propeny and that all construe' confor 0 aU existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
:cial c~rmit for ju caus ore,! y agree that the city officiaI2e;;e~D~~~eny to perform necde~ ~ectioD :::-...._
~ .,. Contractor's License No. Date
/ /
yermit Valuatfon
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 Permit Fee
OWNER
(Name)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
A
I
E
n
F
I
A
R
5
V
M
4
B
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7~751
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I
I
$
$
$
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
r-
Building Ollicinl
Date
PID;;(5 -OOtfJ O/f-o
(Phone)
(Phone)
(Phone)
~~~-~r7-l9tb "3
, Id Z- - ~~- 2 .L.j ~-:. J
OLower Level Finish
o Fireplace
B
S U
PROJECT COST IV ALUE $
(excluding land)
Park Support Fee
SAC
#
$
$
$
$
$
$
$
$
$
7t.,,-
#
Water Meter
Size 5/8"; 1";
Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
#
#
Paid
Date
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Receipt No. 4'(0 qau
By A:'
(J)
fhlS 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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
IbOr/; /'~/I~~
..J
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
,..e-1IINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
[J SEWER HOOKUP
[J PLUMBING FINAL
o MECH FINAL
COMMENTS:
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DATE TIME
1)s~-
'"I '
M-&s:2-
o EXIGRADIFILLING
o COMPLAINT
[J FIREPLACE RI
o FIREPLACE FINAL
[J GASUNE AIR TST
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( CLoS-e ~/p
~WORK~.PROCEED
o CORRECT ACTION AND PR~EED
[J CORRECT ~;~ ~ FOR REINSPECTION BEFORE COVERING
Inspector: P"/': -" Owner/Contr:
--------
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI