HomeMy WebLinkAboutBldg Permit 05-1150
11/17/2005 09:30
5127215727
SAMPSON LINDGREN INC
PAGE 03
Date Rec'd
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE..
AND UTILITY CONNECTION PERMIT
rPlel.'lC tt?e or prinr and aPt ilt bottom)
I ADDRESSj40 <;r[J
o / :;'h 0 (L. Lam..
LOT
BLOCK
LEGAL DESCRIPTION (ollk. u"" ooly)
ADDITION
OWNER. 11\ .
(Name)~ IS.
(Address) \ Lj D ~r
Ii '9'7/,J I
<::;j,~re L.J-/c IJC'
BUILDER S L .\
(Company Name) . CI ~",.- ;~""cN
(Conra", Name) (i,h (II!;. ~a >vJj(orJ
(Address) ;:t.~B Ec<< ~ -gr+i-. ("-f
/l1t7/()~
:~: ~:;, I PERMIT NO. 0.5. //50 I
) y~ow AppliClm
tv/f-
I ZONING(OfficeUK) I
PID
(Phone)
.kc
/j fA (, 1 ~'J I? _Ciil/II
~......-.. .
LIZ_- 7;w ST'-Ib
l. 12. - 7;2 I' S--''It.
fl'1! 15 - /J1 N
(Phone)
(Phone)
5-FltJ 1
TYPE OF WORK 0 New Con'''''""on OOeck Orom ORe-Reofiog ORe-Siding QLOWcr Level FiOlSh 0 F'r<pl.c<
DAddition DAlteration o Utility Connection 0 Misc. L R.Cfo.{r.~~ I. ()(JO
. CODE: 'iz1I.R.C. OI.B.C. PROJECTCOSTlVALUE S )(()-
Type of Coostruction: I U m IV V A B (exclUding land)
Occupancy Group: A B E F H I 1\1 11. S U ~ ^ ()./I I
Division: I 2 J 4 5 rl(e.... \JCLlVltL~ K4t<,r htllAA, O.J "
. I
I hl'rtby cenify lhu [ have furnisbed inrCJl'lTl.ilion on Ihi! application which is to Ihe btst of my blowledlt true and comet. I also cenif'y t~t I .un the I.)wnl't fir aUlhOritcd illl.'nl for Ihe
above-lT'oI:ntloned properTy and thill all corulru<=tion will conform to a.U e:od.1ltinl Slate and 1oc1llaws a'l\d will proceed in aecard.1nce Wilh !ubmiUed plans. 1 am aware lhat Ihe buUditta
~IfKi" <on "CL~~jU"',"" Fun.'~'.l .".by Sit" ..".., oily o"~ial... ."'Bn" 3~;~ upoD tho "",pcny" ."""m n<<d,. ;ir;;'1 D:,----
Signature Contrtctcr'1 License No. j Da.re
I Permit Valua.tion
Pennit Fee
I Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Pennit Fee
I Gas Fireplace Permit Fee
11lVSO"",oc>
sln.7S"
s 7~. S''f
I S 'Z.. SQ
, S
I S
I S
I S
I S
Thil Application Beronues Vow Buildinl PenNt When. Approved
~ ~('[J~
BlIildinl!Officiul
I Park Support Fee
I SAC
I Water M~er Size S18"j I";
I Pressure Reducer
Sewer/Water Connection Fee
J Water Tower Fee
I Builder's Deposit
Other
N S
N S
S
S
N S
1# JS
IS
is
/UJ".OSIS" t.. 79
TOTAL DUE CftUA: D
(q(o. '/<-1 . I ReceiotNo. /, C")// I
ii- 1~-0'j Bv G .
~~ ~k.:J-
nus IS to ctttlfy Ih~llht reqUtU IR the above apphcauon and aCCompanYln, document! IS 10. accardance with the Clry Zonina O,dlnance and may proceed. U I'tqucsttd This dncumcnl '
when signed by the City Plarmrr conslltutes a temporary Cmlfk'atc of Zomna compbal'u:c at'ld allows conSllUchOn to commence Before uccupatlC)', I C~'r\Ificalc tit Oecupan<:y mwt be
ISSued
Planninll; Dirccwr
/f/(,,/or
. On!,
I Paid
I Date
~~
Date: Special COJIdillonl, if uy
14 hour notice for .lIlnspeclion. (9~1) 447-9850. r.. (9!1l1) 44741"!Il
16200 Eagle Creek Avenue Prior Lake. MN SSJ72
..,
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS / L/ 08 'I S~IC~ ~c .<<" C.
TYPE OF WORK F/R-E (l.c...( lJ~i.~tJSU.t.AT1-"i)
USE OF BUILDING S ~ D.
PERMIT NO. 05. / /..9) DATE ISSUED ~ C
BUILDER'S'hW''-S'O,,", - UN ~ ItJ(. PHONE #"Z- ,~"
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
I I
PLACE NO CONCRETE UNTIL ABO~JE HAS BEEN SIGNED
\~::~~~.e) j AIKl.^ . Ibltl:t
FINA~ 1 /J?f!;Y r ,~/J 7 IV};
FOR ALL INSPECTIONS (952) 447-9850
~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
D7 TIME
// /7,~L.
ADDRESS
I t/t7 ,p~/ /<:;4..- vr- ./ k_
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
~N
o SITE INSPECTION
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COWo'l.ENTS) .,......-
.c;/y/ rI'lC~Z/ h:b.-s: /
~--/ /'S-?J
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLINE AIR TST
o
/ /
//I.J/c~
. ,
~.
f_' /
rtP7~
~
/
/ /
\ (~OS-e
AORK SA~RY. PROCEED
;;; ~RECT ACTION AND PROCEED
INSPECTION BEFORE COVERING
Inspector.
~/(
/r: / ~
/-? /~- )
~
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY/
"""""