HomeMy WebLinkAboutBldg Permit 04-0598
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERu.uCATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please tv1Je or Print and sien at bottom)
ADDRESS
~21e
Date Rec' d
(p,/7. of-
I. White File I PERMIT NO I
i ~~71~w ~~~licanl . 04-. 05'} fJ
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LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
(Phone)
(Address)
r~~: NameQZn~~ ~e-_ (<>~~ ~
(contactName)?~~ ~~
(Address) ~'\\ -f.~ ~,",f) ~~. ~~Jbr-
ZONING (office use)
PID 2S: /7S"". 00 I ~ 0
(Phone) -4-Q-l)~" <<{J
(Phone)
~
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TYPE OF WORK 0 New Construction ODeck o Porch ORe-Roofing ~e-siding DLower Level Finish
OAddition OAlteration DUtility Connection 0 MiSC; -
CODE: OI.R.C. OI.B.C. PROJECTCOST/VALUE $
Type of Construction: I II III IV V A B (excluding land)
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
o Fireplace
i ed 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
at 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
r~st~ermore, I hereby agree that the city official or a designee may enter upon the property to perform ~e:p~
Signature Contractor's License No. Date '
Permit Valuation
Permit Fee
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
$
$
$
$
$
$
$
$
Park Support Fee
SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
Other
TOTAL DUE
. This Application Becomes Your Building Pennit Whm Approved
I Paid
I Date
'7 (, .CXJ
(".n .f) L-
Building Otlicial
Date
# $
# $
$
$
# $
# $
$
$
-
$ 7(P. 0 0
Re:fiNo. ~I U>.?
By .
/'
(
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
/ 7 ~ (/ /\/)rA-
ADDRESS ~ / t7 / ...J V
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
C FOUNDATION
o FRAMING
o INSULATION
...e--ANAL
o SITE INSPECTION
o PLUMBING RI
C MECH RI
o WATER HOOKUP
o SEWER HOOKUP
[J PLUMBING FINAL
[J MECH FINAL
COMMENTS:
DATE nilE
.fk/Ar'
. ,
tJ.y-S7tF'
o EXIGRADJFILLlNG
C COMPLAINT
o FIREPLACE RI
[J FIREPLACE FINAL
o GASUNE AIR TST
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.VWORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WO~ C;~OR REINSPECTION BEFORE COVERING
Inspector: j"~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
.J ~~ <", J
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .I SAFETY/