HomeMy WebLinkAboutBldg Permit 04-0181
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
(Please type or orint and sicn at bottom)
ADDRESS II/So
I ~ 5' .3 S?' r ALMviI /IIJ/ \ 7/U
I. White File I PERMIT NO ~ I I
i ~~I~w ~~~licanl . O~ - I f /
1~65'1 tltJ; ~d--"
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION X
OWNER
(Name) TA-S~V
(Address) Z 76 ~ (
K lISEs
tot- ~ ~a1-c1
"
ZONING (office use)
I2L/
PID025"- CJI9-00S-J-,
j..C/.e
(Phone) or ')2,.. 7~ 70 e..{ '7
;f/eC<r f,C<, ~CR /l, ~ ;b C) -, /
~
BUILDER
(Company Name) f' A~€ '5 r:>~ k.,.p;"t'St' ~
(Contact Name) ~oJ./
(Address) "l. 7 6 ~ ( tee ..., l'ih.,...).. ju e.
"
TYPE OF WORK 0 New Construction ODeck o Porch {:(Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration DUtility Connection 0 Misc.
CODE: OI.R.C. OI.D.C.
Type of Construction:
Occupancy Group: A D
Division:
(Phone) q ~'Z.. 75.....'b 70 "f ,
(Phone)
h
I
E
ill IV V A
HIM R
2 3 4 5
D
S U
PROJECT COST/VALUE $
(excluding land)
II
F
I
I hereby certify that I have ftlmished 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 consll1lction will conform to all existing state and local laws and wiJI proceed in accordance with submitted plans. I am aware that the building
:cial can revoke this per~ore, I hereby agree that the city 0:; a ;Si:{ m.; en~; t~operty to p..;".... n;e::;;t:ns_ 0 Y'
~ .7 Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
Plan Check Fee
State Surcharge
Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
/5/. ::J()
Park Support Fee
SAC
.50
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTALDUE
This Application Becomes Your Building Pennit When Approved
...
I Paid /60/.- J
I Date - :::?- 3D-Ol..-
/
Building Otlicial
Date
# $
# $
$
$
# $
# $
$
$
$ /L};J..--
Receipt No. Ut/? L/'::5 r--
By r- ."
~
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 reqllcstcd. This document
when signcd by the City Planner constItutcs a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Ccrtificatc of Occupancy mllst be
issued
Planning Director
Date Special Conditions, jf 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
J/~~-
I
ADDRESS
/6S-?Y fr~~/'~
OWNER
PHONE NO.
o FOOTING
CI FOUNDATION
o FRAMING
o INSULATION
~L
o SITE INSPECTION
COMMENTS:
/7 /)
/Le~ r
~
/ /'
( /'CCfJ.s-e
,---:-
CONTR.
PERMIT NO.
ttW... /3'/
o PLUMBING RI
CI MECH RI
CI WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
CI COMPLAINT
CI FIREPLACE RI
[J FIREPLACE FINAL
o GASLlNE AIR TST
[J
........-J J /
(' o.;-/) u re
f.
/
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..--- ----
~~
r-r / ' )
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--------
~WORKSAnSFACTORy.PROCEED
o CORRECT ACTION AND PROCEED
CI CORRECT WC:~A C,L FOR REINSPECTION BEFORE COVERING
Inspector: /K//'./ Owner/Contr:
~
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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