HomeMy WebLinkAboutBldg Permit 05-1087
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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City
Applicant
(Please type or print and sign at bottom)
ADDRESS
/5(P73
/ft-/t/V 0 VI Eh/ ~.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name) Do",
,
,
I
f-klr,r K\flV)
4 ncfo.e
(Phone)
(Address)
BUILDER 6
(Company Name) ~~/I, ~_~C1tl.Jvt
(Contact Name) $r"""lr\.\. ~
(Address) I 0 ~ I ~a vII", W( ~~ eo..
Date Rec' d
feJ. ~fv 0.:;-
PERMIT NO.05, /067
ZONING (office use)
PID 2-5, ZSZ- _ ~ 04 _ 0
1s-- J-. lJ'ID 6t1C,c;
~,{):J.Ath .:t "C, (Phone) ~r( -773-'3 (,7S--
(Phone)
Si-.11:t~11 rI1A/ SJtOfe,
TYPE OF WORK 0 New Construction ODeck o Porch ~-ROOfing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Conn~
CODE: DI.R,C, DI.B,C,
Type of Constmction:
Occupancy Group: A B
Division:
o Mi<r
II
F
I
III IV V
HIM
234
A
R
5
B
S U
PROJECT COSTIVALUE $
(excluding land)
I
E
I hereby certifY that 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
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 buildmg
:fiClal can rev~e~hlsZ=e FllIthel'S' I hereby agree that the City offiClal or a desIgnee may enter upon the property to perform n7:d IJ~;/ (J5-
-e,J Signature Contractor's Ltcense No I date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Pennit When Approved
Paid 7f.,-
Date I(). z,~..Or-
l3uildlllg Otlicial
Date
# $
# $
$
$
# $
# $
$
I $
I $ J&, .0 ()
RecMNo. .q;.~4-7
f3Jrf ),
rf
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 constltutcs a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate llf Occupancy must bc
issued
Planning Director
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
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
l\_~
ADDRESS I '5 tJ "l. ~
T S\a-1 \I"H..\
OWNER
CONTR,
PHONE NO,
PERMIT NO,
t;'/oel
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/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
~ ~wa~ "4oeAt7V\_
".t. -k rJb~ ~ +?"l
- -- L -\.
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORR~RK, CALL FOR 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!
1NSN01l