HomeMy WebLinkAboutBldg Permit 04-0014
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. It. ()4-
l. White File I PERMIT NO
2. Pink City . 04-, 00/4--
J. y.now Applicant
(Please type or print and sil!ll at b~..~~)
ADDRESS ZONING (office use)
5"/ 00 /f1@v1 O,,",,"-L-
I ,~( ,
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
(Address)
(Phone)
BUILDER r-
(Name) \(iJU -t"ofL.\ EO "'(i~ (~-r
(Contact Name) ~ 1=11.l6:.j) ~fi....~
(Address) \~"C)c....O s.. 1=""LAt.JCd~ L..s Pn,on
TYPE OF WORK
o Misc.
(Phone)
(Phone)
&.u.
o New Construction
o Porch
~Re-ROOfing
OAlteration
/ez..
PID z.s: DO+-. 004-. I
ct S 2.- 4 ~ ., - 'B ~2-
\.0 \1.... S. q 0 ,.... SS S- G\
ORe-Siding
OUtility Connection
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
enter upon the property to perform needed inspections.
X }LR'c... ~-A ~
Signature~
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
o Deck
OLower Level Finish
OAddition
o Fireplace
PROJECT COST IV ALUE (excluding land) $
Contractor's License No.
z, SO o. 0 0
Park Support Fee
SAC
$
$
$
$
$
$
$
$
Water Meter Size 5/8"; I";
Pressure Reducer
City SAC and WAC
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
I Paid
I Date
'7(,. () c) ~
/./~.oY
, I
This Application Becomes Your Building Permit When Approved
Building Official
Date
\ - l'L..- () Y
Date
# $
# $
$
$
# $
# $
$
$
$ 7(,.00
_/1 - -
ReceiptbT6. ~ UI /J'
BVO
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, tax (1)52) 4474245
16200 Eagle Creek Avenue Prior Lake, MN 55372
.\'>.,.,
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
~-
ADDRESS
s/aY $eMO~~./
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
a1!fNAL
o SITE INSPECTION
COMMENTS:
/7 /J
/Cerod r::
CONTR.
PERMIT NO.
~y -/y'
o PLUMBING RI
o MECH Rl
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASUNE AIR TST
/'0
/"'? .~"
(Cpt//) /....~ e.
,
---
/---:/ =~.. ~
\.~~se /-7 !>-~
"XWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~~::~'}OR REINSPECTION BEFORE COVERING
Inspector: /~ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETYI
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