HomeMy WebLinkAboutBldg Permit 04-0181
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1. White File
2. Pink City
3 Yenow Applicant
(Please type or print and sip at bottom)
ADDRESS /fISo
I t,6- 37 r~//'IJ \7A/
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION X
OWNER
(Name) Tf}st) V
(Address) Z 76 i:] (
k MEc;
tOl- ~ ~O?-cI
;'
k~
ZONING (office use)
Rtl
PIDaS"- CJI9-00S-()-
(Phone) or,,-z.. 7 ~ 7 (:J '-11
;f/e Gv- f,C(. c,cR /l,..,;b c> -, /
.;
BUILDER
(Company Namet r Av;€"5 F~ /t-...,,~tSt' ~
(Contact Name) ~oV
(Address) "l.. 7 6? .( tr;c" G'h,.,J..... Jl.o e..
"
TYPE OF WORK 0 New Construction o Deck o Porch p(Re-Roofing ORe-Siding DLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection 0 Misc.
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
ill IV V A
HIM R
2 3 4 5
(Phone) q ~'Z.. 7 5-~ "70 e...r ~
h
(Phone)
B
S U
PROJECT COST IV ALUE $
(excluding land)
II
F
1
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-menl1oned 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
;ciaI can revoke this per~ore. I hereby agree that the city 0:; aisi:; r;en4F; t~operty to p....;v.... n;e:;t:ns~ 0 y
~ 7 Signature Contractor's License No. Date
Permit Valuation
Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
15/. ;ilJ
.50
This Application Becomes Your Building Pennit When Approved
Building Ollicial
Date
Park Support Fee
SAC
$
$
$
$
$
$
$
$
$ 1Ll'::l.,--
Lf('(?~-~~
#
#
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I WaterTowerFee
I Builder's Deposit
I Other
I TOTAL DUE
#
#
I Paid /5 d . -- I
I Date -:::?- 3D-Ol-1
/
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
OA TE TIME
{/~-
ADDRESS
/6S3Y fr~Li,~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
A'fINAL
o SITE INSPECTION
COMMENTS:
/J ()
/Le~r
CONTR.
PERMIT NO.
&/.../t?/
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
.........., J /
(0'- /) /6 r-e
/
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---------
~WORKSAnSFACTORy.PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~4 ~ FOR RElNSPECTIOH BEFORE COVERING
Inspector: /~/ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECnON 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SA.FETY/
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