HomeMy WebLinkAboutBldg Permit 05-1026
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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(Please type or print and sign at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT ~LOCK
ADDITION
OWNER
(Name)
Oe..b,b I 'e
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
Date Rec' d
White
Pink
Yellow
I PERMIT NO. p()- /O~+
File
City
Applicant
ZONING (office use)
(Phone)
(Phone)
TYPE OF WORK D New Construction DDeck DPorch ~Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility ConnBon
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
llIIV
H I
2 3
V
M
4
II
F
I
A
R
5
I
E
o Misc.
B
S
U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certity that I have filrnished mformation on this application which is to the best of my knowledge true and correct. I also certity that [ am the owner or authOrIzed 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 buildmg
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, ... i/ Signature Contractor's License No. ' Da
Permit Valuation :J-S-CO.- I
Permit Fee $ /4~~~ I
Plan Check Fee $
State Surcharge I $ /~;;J5-
Penalty $ I
Plumbing Permit Fee $ I
Mechanical Permit Fee $ I
Sewer & Water Permit Fee $ I
Gas Fireplace Permit Fee $ I
This Application Becomes Your Building Permit When Approved
Buildllll! 011ieial
Date
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
$ /j~;,"'-
S'uCJ91
--
Paid
Date
r it.,
II) ,. I '-1..- 00
Receipt No.
By CI
r
ThiS IS to eertity 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 conSl1tutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy 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
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o I~TION
,...erFINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL /J
~//rY.)r/
COMMENTS:
-
// /
/; c JZ,es
~ ;;Z; /'l
/ -
DATE TIME
s- - /CJ.2~
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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P YORK SATISFACTORY, PROCEED
?6 CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR INSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
.....
mINOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!