HomeMy WebLinkAboutBldg Permit 04-0536
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please tv1Je or print and sip at bottom)
ADDRESS
3/~1
I. White File
2. Pink City
3 Yellow Applicant
S#?1 0 y'
,o()/IV/
t,Ov'e,
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
(Address)
(Phone)
BUILDER + \
(Company Name) C. R-. O[)f\ ""~c.....t"t:) r- So
(Contact Name) jS, \ \ :S-O \ \-\-~
(Address) 75010 /ClOT/-I Sf, /". ,hI" LP~
Date Rec' d
fd..3. Of-
PERMIT NO. 64-. 053&
ZONING (office use)
PIDZ5. '511. (J/7. 0
(Phone) "t;J. - 4Qo .,.. ~d. q ~
(Phone)
ml'J
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing l2l'Re-Siding DLower Level Finish 0 Fireplace
OAddition OAlteration DUtility Connection 0 Misc/,
CODE: OJ.R.C. OJ.B.C.
Type of Constnu:tion:
Occupancy Group: A B
Division:
J
E
ill IV V A
H J M R
2 3 4 5
B
S U
PROJECT COST IV ALUE $
(excluding land)
II
F
I
I ht'feby 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 authorized agent for the
above-mentioned property and that all consltuction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
~~:"~i\3t cause. FU~hermore, I hereby agree that the city official or a designee may enter upon the property to perform 2e::;t: t-('
Signature Contractor's License No. Date '
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
, Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid
I Date
7u. ()(i
(. . J. 0"'--
This Application Becomes Your Building Pennit When Approved
Buildinl! Otlicial
Date
# $
# $
$
$
# $
# $
$
$
$ 7~. ~?J
n '
RectNo. h'P7<tF-
Bv __,
G
ThiS IS to certify that thc request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requestcd. This document
when signed by the City Planner constitutcs 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
~~s~
-/ r
TIME
ADDRESS
3/bE dLv- a~
/
CONTR.
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~~L
o SITE INSPECTION
COMMENTS:
/7 /
/4, I dfl1~
PERMIT NO.
(!)/--SJ 6
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
D COMPLAINT
D FIREPLACE R1
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~4_
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOrl