HomeMy WebLinkAboutBldg Permit 04-0244
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please tvve or print and si2l1 at bottom)
ADDRESS
Date Rec' d
I. White File I PERMIT NO oil ~ J
2. Pink City .' _.., J 14
3 Yellow Applicant C>t. ...,
I ~ 4 (" f)
11~ r1re--
ZONING (office use)
e~
LEGAL DESCRIPTION (office use only) j)
LOT BLOCK ADDITION 4~ O~
......
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(Address) I&qto ./ );L<jJ 4Y
- .r f
BUILDER
(Company Name)
(Contact Name)
(Address)
PID'dS- C;O(J..- /3 )-(~
/1 (Phone) ~);2- </<//)- ROLJ..J
/::iUfr I ~ U;u 0537.:2
(Phone)
(Phone)
TYPE OF WORK 0 New Construction DDeck o Porch ORe-Roofing ~Re-Siding OLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection 0 Misc./l'
CODE: DI.R.C. DI.B.c.
Type of Constmction:
Occupancy Group: A B
Division:
ill IV V A
HIM R
2 3 4 5
/1
ap c on which is to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
nfo to all existing state and local laws and will proceed in accordance with submitted plans. I am aware th7t the b ilding
, I eby agree that the City official or a designee may enter upon the property to perform needed Inspections.
~- tj ,-()
\ Contractor's License No. ' Date /
I
E
II
F
I
x
I Permit Valuation
I Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
~
J6{)(),--
$ - '74-76
$ I'a.-~
$
$
$
$
$
$
This Application Becomes Your Building Pennit When Approved
Building Otlicial
Date
B
S U
PROJECT COST /V ALUE $
(excluding land)
I Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$ /)<- J -
Receipt No. ii(P ':'/5Q
BY~
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
#
#
I WaterTowerFee
I Builder's Deposit
I Other
I TOTAL DUE
r-! ' ,..---
lip :. ,
f.;/..... '-1-(/1
-
I Paid
I 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
DATE TIME
{p;:/ar
ADDRESS
/61/~o ~U/V #-
OWNER
PHONE NO.
o FOOTING
[] FOUNDATION
[] FRAMING
[] INSULATION
)l'"ANAL
[] SITE INSPECTION
COMMENTS:
11 / /
/?e5/de
CONTR.
PERMIT NO.
e#-2~</
o PLUMBING RI
[] MECH RI
o WATER HOOKUP
[] SEWER HOOKUP
[] PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
[] COMPLAINT
[] FIREPLACE RI
[] FIREPLACE FINAL
[] GASLlNE AIR TST
[]
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bl'WORK SATISFACTORY, PROCEED
18' ~ORRECT ACTION AND PROCEED
[] CORRECT WO~~~;.7 REINSPECTION BEFORE COVERING
Inspector: --F~t-- Owner/Contr:
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH &: SAFETY/
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