HomeMy WebLinkAboutBldg Permit 04-0606
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERll.UCATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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3 Yellow Applicant
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LEGAL DESCRIPTION (office use only) /J
LOT IBLOCK 4-ADDITION ~ ~(~
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BUILDER
(Company Name)
(Contact Name)
(Address)
Date Rec' d
PERMIT NO. 4" _~(!)"
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TYPE ozwa 0 New Construction ODeck o Porch f){Re-Roofing ORe-Siding OLower Level Finish
OAddition OAlteration DUtility Conn1tion 0 Misc.
CODE:I.R.C. DI.B.C. PROJECT COST/VALUE $
Type of Construction: I II ill IV V A B (exc1udingland)
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
o Fireplace
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I herebY~erti that I ve 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 agent for the
above-men ned pro rty and t t onstruction will c I'm to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official ca IS permit J t use. rtherm , ereby agree that the city official or a designee may enter upon the property to perform needed Inspections.
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V Signature Contractor's License No. - Date
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I Park Support Fee
I SAC
Water Meter Size 5/8"; 1";
I Permit Valuation
I Permit Fee $
I Plan Check Fee $
State Surcharge $
Penalty $
I Plumbing Permit Fee $
I Mechanical Permit Fee $
I Sewer & Water Permit Fee $
I Gas Fireplace Penyit Fee '- $
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ThIS is to certify that the requesi 10 tile aPove 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
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Pressure Reducer
I Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
I TOTAL DUE
I Paid
I Date
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$
$
$
$
$
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$
$
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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
DATE TIllE
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OWNER
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CONTR.
ADDRESS
PHONE NO.
PERMIT NO.
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o FOOTING
o FOUNDATION
[] FRAMING
o INSULATION
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[] SITE INSPECTION
o PLUMBING RI
o MECH RI
[] WATER HOOKUP
o SEWER HOOKUP
[] PLUMBING FINAL
o MECH FINAL
[] EXIGRADIFILLlNG
[] COMPLAINT
[] FIREPLACE RI
[] FIREPLACE FINAL
[] GAS LINE AIR TST
[]
COMMENTS:
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XWORK SATISFACTORY, PROCEED
[] CORRECT ACTION AND PROCEED
[] CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETYI
INSNOTl