HomeMy WebLinkAboutBldg Permit 04-0568
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERIUICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
I. White file I PERMIT AI J blt)
i ~~71~w ~:;licanl NOoU'-1' - ~ S ~
(Please fY1Je or print and siJEll at bottom)
ADDRESS ZONING (office use)
/ t, 539
::;-~ T t--
LEGAL DESCRIPTION (office use only)
LOT fa BLOCK / ADDITION P ~ fu;...
PID~!:). 0/'7- t'O~-O
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~=R L::)19 ua !//z,~L /h H t' V4/~C~/ (Phone)
/~3q ~A~g"" 7A. ~E~
~~~~~NametPv~-L~ ~~~6-'c.( Lib - (Phone) 9..0- ~/-;OS\
(Contact Name) ,n~vf /?&~~~, ~~ ~ _jPhone)-.P/-Z -r:S"'&:,/-jd6<1--
(Address) ~t? 8-~ ~~~ y;~~ 6,c/ /~ ~V" &-r-LP"<d
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TYPE OF WORK 0 New Construction ODeck OPorch MRe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Conne~ 0 Misc.
(Address)
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
n
F
I
ill IV V A
HIM R
2 3 4 5
x
I Permit Valuation
I Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
~~7-th 9'9'..:?
- ~
B
S U
PROJECT COST /V ALUE $
(excluding land)
ion which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the
to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
ereby agree that the city official or a designee may enter upon the property to perform needed IOspections.
~~~t:J/?7yr/ ~--/d-CJf/
Contractor's License No. Date'
I ~ 5""00
, $ 7C/. 7.S-
I $ I... ~S-
$ I
$ 1
$ I
$
$
$
This Application Becomes Your Building Permit When Approved
Building. Ollicial
Date
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
I Builder's Deposit
Other
TOTAL DUE
r Paid
I Date
, /Cp.-
G;, - 10 -(J '-I
I
$
$
$
$
$
$
$
$
$ 7&.--
ReceiptNo.4'~~S <1
. By [j--)
#
#
#
#
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
DATE nME
CITY OF PRIOR LAKE ./ oL.
INSPECTION NOTICE SCHEDULED, r (~..s '"
ADDRESS -./6539 h~r>))~
PHONE NO.
OWNER CONTR.
PERMIT NO.
#-s~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~L
o SITE INSPECTION
COMMENTS:
/J ()
14>,oor
-
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
/:? 1 /
CP~~ /e 77E..
,
~-
~
/ ~/ ~/
( L;/~s-e /~~~_~
~O~~A~IUK..~R~EED
o CORRECT ACTION AND PROCEED
o CORRECT WO~K;,..~A~O~ REINSPECTION BEFORE COVERING
Inspector: ~.k/ Owner/Contr:
-
.~
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CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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