HomeMy WebLinkAboutBldg Permit 05-0060
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CITY OF PRIOR LAKE BUILDING PERMIT, ~'<-~ d. :'d~ Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE 4lD ,00 I I ti O{
AND UTILITY CONNECTION PERMIT ~ .,.
L While File
2. Pink City
3. Yellow Applicant
PERMIT NO. C6. OO~O
(Please type or print and siJPl at bv..u~)
. ADDRESS ~~3l\ (b'fe.e.n \-\e:\~nt,S \'f'O..iL
ZONING (office use)
Ie/50
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID 25. 09+-. OO~, 0
OWNER
(Name) (Y)l..r('f) 'f*'C(J'<Y""\
(Address)~~~L\ bn'"~.n \-\l.\Qn~S\R "
u
BUILDER ,
(Name)-W H"'(\r'i U ~r'lnr~ m N, ,J:\,\(l-
(Contact Name) ~ f\.o n, 0 l c::;~n
(Address) C\C\D
(Phone) qnri.- dd.\.Q-L\ Oq ~
\'(\DY ha~O., mY') ~:Sil
~ .
OLower Level Finish
Lon.l-Ofb5-DI05
~
m N. fiS \0.'
/' ----
~e-Siding ,)
-
o Fireplace OAddition OAlteration OUtility Connection
PROJECTCOST/VALUE (excluding land) $ a;:~}1 <6~ .Ot>
(Phone)
(Phone)
h...D~ OlUG Rd *\ \4) y~ \
TYPE OF WORK
o New Construction
DDeck
DPorch
ORe-Roofing
o Misc.
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 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 just cause. Furthermore, I hereby agree that the city official or a designee may
rb;;"r;~:~"'" aD \ Lo?-l~~ \ - \;;) - Of')
9 Signature Contractor's License No. Date
I Permit Valuation I I Park Support Fee #. $
I Pennit Fee $ I SAC # $
I Plan Check Fee $ Water Meter Size5/S";I"; $
I State Surcharge $ Pressure Reducer $
I Penalty $ I City SAC and WAC # $
I Plumbing Permit Fee $ I Water Tower Fee # $
I Mechanical Permit Fee $ I Builder's Deposit $
Sewer & Water Permit Fee $ I Other $
Gas Fireplace Pennit Fee $ I TOTAL DUE $ '1 ~. () 0
I
This Application Becomes Your Building Permit When Approved
Paid
Date
~~.- t/U
. ~;XJ..~
ReceiPt~h~1'tt, 5"Z..
BY~
Building Official
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) 4474245
16200 Eagle Creek Avenue Prior Lake, MN 55372
DATE TIME
CITY OF PRIOR LAKE 5-~
INSPECTION NOTICE SCHEDULED
ADDRESS Z <6"3 {{. ~ ..-r~
OWNER CONTR.
PHONE NO. PERMIT NO. _ <;";, c:!. I ~ 5-GO
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
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COMMENTS:
-
-
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7_ ',/ )
I I l....P
~
o W~ATISFACTORY. PROCEED
c::::&CORRECT ACTION AND PROCEED
o CORRECT ~~~~ REINSPECTION BEFORE COVERING
Inspector: 1JLf' Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH & &4~IH 1'1
INSNOTl