HomeMy WebLinkAboutBldg Permit 04-0181
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERIUICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
(Please type or JJrint and sip at bottom)
ADDRESS II/Sa
. I t, 5" 3 ~ r ALMtJI /111/ \ 7A.-J
1. White File I PERMIT NO
i ~~~~w ~::Iicanl . 0'-1- I f /
/ bS- :f" I /.j tJ; ij;;-"
LEGAL DESCRIPTION (office use only)
ADDITION X
LOT
BLOCK
OWNER
(Name) Th-St' V
(Address) Z 76 e; (
kMEs
t oz,., c.,L~ -c:I k~
"
ZONING (office use)
12'/
PIDas-- CJlq-oos-~
(Phone) or,,2, 7~ 7 ~ e-{ ?
PeGv' tree. c"cR /l. ~ i:b C) f /
,;
BUILDER
(Company Name) r A~€ s Ft:'? ;4-,#~t'S~ ~
(Contact Name) ->>:...t-:Jrs;oV
(Address) "l. 7 6 -;- ( L-cc..., 14'~"'",{ .JC/ e.-
"
TYPE OF WORK 0 New Construction o Deck o Porch j)'(Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection 0 Misc.
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
1
ill IV V A
HIM R
2 3 4 5
(Phone) QC-7- 75-'~ 70 e...r ,
"
(Phone)
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 aU construction will conform to all existing state and local laws and will 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:{ 3en~S t~roperty to perform n~e~;t:ns~ 0 y
~ ;:::;' Signature Contractor's License No. Date
Permit Valuation
Permit Fee $ /5lSD
Plan Check Fee $
State Surcharge $ .50
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When A. .. . ,ed
Building Ollicial
Date
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I SewerlWater Connection Fee
Water Tower Fee
Builder's Deposit
lather
I TOTAL DUE
...
I Paid /5 d . -- ,
I Date - ::7- 3D-oL-1
/
#
#
#
#
$
$
$
$
$
$
$
$
$ I~J,~
U~l/BK"
I
Receipt No.
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 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
/6S-?Y fr-NrL~~
OWNER
PHONE NO.
o FOOTING
[] FOUNDA nON
o FRAMING
[] INSULATION
A'fINAL
o SITE INSPECTION
COMMENTS:
/J I)
/Le I1t?o r
~
/' /'
( /'/~ S-e.
'---
CONTR.
PERMIT NO.
o PLUMBING RI
[] MECH RI
[] WATER HOOKUP
[] SEWER HOOKUP
[] PLUMBING FINAL
[] MECH FINAL
DATE TIME
{/2f6.s -
&/... /tY/
o EXIGRADlFILLlNG
[] COMPLAINT
[] FIREPLACE RI
[] FIREPLACE FINAL
o GASLlNE AIR TST
o
~ J /
,- O~;{) /e r€
/
----:::::=----
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~ WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~~A C,L FOR REINSPECTION BEFORE COVERING
Inspector: /q / Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI