HomeMy WebLinkAboutBldg Permit 04-0522
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please We or 1Jrint and sign at bottom)
ADDRESS
/5Z11
Date Rec' d
6;, //-0 f-
I. White File I PERMIT N
2. Pink City O. 0 f- /'l 5L 'Z-
3 Ye\low Applicant .. V
0/1 K-/2.t O~€
Uff-
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(N ame)
(Address)
(Phone)
BUILDER /'. tI7,
(Company N'ame) ,'.) (... " l't1o-..d f 1(....0""..$\ '" t:.
(Contact Name) ~ (I r~ <. ~l. __': ,.C.J.-
(Address) \ b tg u .. ~ ~,~ <; 4 ..
ZONING (office use)
PID 2.S". ?.~/.. b 0 'L. tJ
(Phone) ~.s-:>> - ~ifi-I.i flst4J
(Phone)
MN tr3~~c
13 { e> Q--,'h-
/.
o New Construction ODeck OPorch ~~1-ROofing ORe-Siding
OAddition OAlteration OUtility Conn~ 0 Misc.
TYPE OF WORK
CODE: OI.R.C. DI.B.C.
Type of Constmction:
Occupancy Group: A B
Division:
OLower Level Finish 0 Fireplace
I
E
II
F
1
B
S U
PROJECT COST /V ALUE $
(excluding land)
III IV V A
HIM R
2 3 4 5
I hereby certify that I have fumishe information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
above-men 6Jl1 property and th c nstruction will co rrn to aU existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official c rClJ^e this permit for' t c se. Furthermor ereby agree that the city official or a designee may enter upon the y.uy,.., to perform needed Inspections.
X .-~/ t;,.../...Ol.{
~ ) .. Contractor's License No. Date -
I ./
I ~Valuation
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
$
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I WaterMeter Size5/g"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
Builder's Deposit
Other
I TOTALDUE
This Application Becomes Your Building Pennit When Au-. "ed
I Paid
I Date
7~.vV
~ f. d?-
Building Otlicial
Date
#
#
#
#
()
Reccli~ No.
By r--,
(f
$
$
$
$
$
$
$
$
$ 7f(;.() 0
,
9'V 'h 4-- I
I
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 constitutcs a temporary Certificate of Zoning compliance and aUows 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
ADDRESS
/.J2//
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
J1lJ ' rllolAL
o SITE INSPECnON
COMMENTS:
/J //
/~OC> r
DATE TIME
~",
O~~ ~kp
J
~-&22-
SCHEOULED
CONTR.
PERMIT NO.
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
/:? //
Ca~ / /eT~
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( (' ~ (d5e. // / e.-- /
d"WO~OCEE~
~ CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
--
~-----
~ ~~--
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CALL 447-'8~~ Ff;)R THE NE;XT INSPECnON 24 HOURS IN ADVANCE.
CODE REQUlREMENTSA.RE FOR YOUR PERSONAL HEALTH & SA..",H''1
INSNOTl