HomeMy WebLinkAboutBldg Permit 04-0450
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or lIrint and sip at bottom)
ADDRESS
Date Rec'd
5. /4-.04-
I. White File I PERMIT
2. Pink City NO. 0 A . 0 A~
3 Yellow Applicant ~ ~V
5.5 z e S' ffO f'bG 77eA' / L-
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
(Address)
Bun..DER
(Company Name)~
(Contact Name) ((.~.J.l
(Address) \ t...01...O
(Phone)
f"a...1LO~ LO~T
h. I ,-oc...f~
S1- ~~ ~
p ",-, " ilL..
(Phone)
(Phone)
L.~ Y1~
TYPE OF WORK 0 New Construction ODeck DPorch <<R1-Roofing ORe-Siding
OAddition DAlteration DUtility Conntftion 0 Misc.
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I ZONING (office use)
PID 'z5". Z15. 100.0
'tS'2.- 4~1 - IQ~2.
S~J72-.
OLower Level Finish
I
E
II
F
I
B
S U
PROJECT COST IV ALUE S
(excluding land)
ill IV V A
HIM R
2 3 4 5
o Fireplace
I hl'1"eby 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 permit for jurse. urthermore, I hereby agree that the city official or a designee may enter upon the property to perform necded Inspections.
X JLJ,l. L r S-'Y - O~
SignatuO Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
2, SOD.DO
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
$
$
$
$
$
$
$
$
Builder's Deposit
Other
I
I TOTAL DUE
This Application Becomes Your Building Permit When Approved
I Paid "it . () 0 "
I Date - 5. I~IJ ~
, /
Building Otlicial
Date
#
#
#
#
$
$
$
$
$
$
$
$
$ 7(,~OO
/l
Rec~t No. ~q
BY4-. ,
d
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 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
DATE TIME
fh~QS-
ADDRESS
S5:;~ '- )Ar;y''f:- 7/(
OWNER
CONTR.
PHONE NO.
PERMIT NO.
~-~s-o
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.l!!l""FlNAL
o SITE INSPECTION
o PLUMBING RI
o MECH RJ
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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,
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/4' Ie. /
-
~RKS ORY
o CORRECT ACTION AND PROCEED
o CORRECT WORK~ C~: F~EINSPECTION BEFORE COVERING
Inspector: / ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .I SAFETY!
_I