HomeMy WebLinkAboutBldg Permit 05-1157
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and si!l:n at b, __ _,.)
ADDRESS
14tfJ.L/
Date Rec' d
~i~i~e ~:~y I PERMIT NO. /)c _ _ / J z:- /t1
Yellow Applicant I/d / / :.; ~ 11
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LEGAL DESCRIPTION (office use only)
LOh([ BLOCK
1
OWNER
(Name) .
, Ti.ACl ; -{.t\
(Address)
BUILDER
(Company Name) tie I ()
(Contact Name) /l" b
I (Address) bl5"3 fA)
ADDITION
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PID Iff/-Odd-
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/ '13 y~ 51..
(Phone)
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(Phone)
(Phone)
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TYPE OF WORK 0 New Construction ODeck OPorch pcffie-Roofing
OAddition OAlteration OUtility Connfctic;n
o Misc.
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group:
Division:
A
B
I
E
II
F
I
A
R
5
ORe-Siding OLower Level Finish
B
S U
PROJECT COST/VALUE $
(excluding land)
ZONING (office use)
tS1
~'1'
33y'J
116'
III IV
H I
2 3
V
M
4
vI/v
2/"W
o Fireplace
I have furnished mformation 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
[ perty an that all construction will conform to all exisl1ng state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
, IS rm _ r~use Furtheere. I hereby agree that the CIty official O:z.:Si;;~ t3e,?r ~on the property to perform need/17;;11J)_
Signature Contractor's License No. ' rfate
x
I Permit Valuation
I 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
~ C;O().----
$ /L-I- 7~
$ . ,
$ Ifd..~
$
$
$
$
$
This Application Becomes Your Building Pennit When Approved
Buildmg Otlicial
Date
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$ '7b.--
Receipt No,~ OC; I Ly
By CJ '
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. TIllS document
when signed by the City Planner constItutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy. a Cerllficate of Occupancy must be
issued
Planning Director
Water Meter Size 5/8"; 1 ";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
#
#
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
Builder's Deposit
Other
TOTAL DUE
----
Paid / It-" --
Date J/-;)I-OCJ
I U.
,4SPECTIO~h_,. -cE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
J L/l-/2 i/
I/I&L.~ J_\ ~
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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DATE TIME
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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( -+ V~
~ SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT :O~ CA:~INSPECTION BEFORE COVERING
Inspector: V V7 Owner/Contr:
CALL 447-9850 F(>R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
lNSNon