HomeMy WebLinkAboutBldg Permit 05-0267
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ADDRESS J
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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White File I PERMI
Pink City T NO. /') S (}'ZfR7
Yellow Applicant (,/' p
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BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
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(Phone)
9~2
OWNER
(Name)
ZONING (office use)
PIDr.25 -001- /13 -6
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TYPE OF WORK 0 New Construction ~eCk OPorch ORe-Roofing ORe-Si4ng OLower Level Finish
OAddition OAlteration OUtility Connection 0 Misc, '
CODE: ~.R.C. DI.B.C. PROJECTCOST/VALUE $
Type of ~stroction: I II III IV V A B (excluding land)
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
4- 7 J,
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(Phot)
(Phone)
177 ;../
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I hereby certifY that I have htrnished mformation on this application which is to the best of my knowledge true and correct. I also eenifY that I am the owner or authonzed agent for the
above-mentIOned property and that all construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans, I am aware that the building
official can~evoke this perm~ for Just cause. Fmthermore, I hereby agree that the CIty official or a designee may enter upon the property to perform needed mspections,
X ,,(,:14 J5(':~.:~, :lo;L 77'.s-?~ ~A/p~
. I / si'gnature Contractor's License No. / ofte
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
# /~OtJ, (JO
$ 57,.50
$ 37.38
$ , 7S-
$
$
$
$
$
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
~;;;tn:Buil'm.pum> ;i;;n'
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Paid
Date
~5-' ~ 3
4. ..v:{)J~
I Receipt No, fi-e?tf:-
I By re--
$
$
$
$
$
$
$
$
$
9s-. ~3
ThIS IS to certifY that the request in the above applicatIon and accompanying documents is in aecordance with the City Zoning Ordinanee and may proceed as requested. This document
when signed by the City Planner constItutes a temporary Certifieate of Zoning compliance and allows construction to commence, Before oecupancy, a Certtficate of Occupaney must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any
",
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS 45f}q C{)L-()~OO .=, I ~
TYPE OF WORK Ot;7~
USE OF BUILDING ~..s~ p/,e
PERMIT NO. 0:;-. 0 2~ 7 I DATE ISSUED 4, l3, 05"
BUILDER J"t!A-;<p0 1t./6 PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOjl "'ATE j
FOOTING I /4t"J- I 11/J /tJS
PLACE NO CONCRETE UNTIL ABOVE H~S BEEN SH}NE,D
FRAMING ~ ~ t:J...s. I ~ I L//lt//~
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, FINAL
FOR ALL INSPECTIONS (952) 447-9850
ADDRESS
L/s- Y9
DATE TIME
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SCHEDULED
CITY OF PRIOR LAKE
INSPECTION NOTICE
;;
OWNER
CONTR.
PHONE NO.
PERMIT NO.
OS--.2~ >
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MEcH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS: /J /
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/ U/C
~ORK SATISFACTORY, PROCEED
/O'cORRECT ACTION AND PROCEED
o CORRECT 7;K/C~R REINSPEcTION BEFORE COVERING
Inspector: /'~ ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTI