HomeMy WebLinkAboutBldg Permit 04-0490
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
s: z. f"o4-
I. White File I PERMIT NO d-, I
i ~~~I~w ;;;Iicant . 0 T " 0 4f 0
(Please type or print and sign at bottom)
ADDRESS 33G.? 0 /JrtL..r/7Yl 5"7
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 2>: /72.-,,0/2.-. (L
OWNER
(Name)
(Phone)
(Address)
BUILDER "'/
(Company Name) ,- t/t' 5/w~ tv
(Contact Name) PAV~
(Address) "7 &::? 0
(Phone) 767 :7?/ - t:1.71J 9
(Phone)
/ .3 ?".I AV<.
/
TYPE OF WORK 0 New Construction ODeck o Porch ~~e-ROofing ORe-Siding
OAddition OAlteration OUtility Conn~ 0 Misc.
;V
OLower Level Finish 0 Fireplace
CODE: OI.R.C. OI.B.C.
Type of Constroction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby 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 construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
official can revoke this ~rmit for just caus urtherrn e, I hereby agree that the City official or a designee may enter upon the property to perform needed Inspections.
X ~ Signature Contractor's License No. f:Qt1'1JI.
I Permit Valuation I Park Support Fee # $
I Permit Fee $ I SAC # $
I Plan Check Fee $ I Water Meter Size 5/8"; 1 "; $
I State Surcharge $ I Pressure Reducer $
I Penalty $ I Sewer/Water Connection Fee # $
I Plumbing Permit Fee $ I Water Tower Fee # $
Mechanical Permit Fee $ Builder's Deposit $
Sewer & Water Permit Fee $ Other $
-
Gas Fireplace Permit Fee $ TOTAL DUE $ 7f,.rJO
This Application Becomes Your Building Permit When Approved Paid '7'''00 Rece{}o 4f4f!;;O
Date ~, z-f-.-t 4- By ~..
Building Otlicial Date ()
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
ADDRESS
Ji'bt!J ~~q'~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.D--PINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
.4 /J
/~r"~ I
DATE nUE
-P~S-
C'~- s/f'o
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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YWORK SATISFACTORY, PROCEED
Ie;'- ~ORRECT 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.
~. ..loI .1...,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/