HomeMy WebLinkAboutBldg Permit 05-0962
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and si~n at bottom)
ADDRESS
Date Rec' d
I. White
2. Pink
] Yellow
File
City
Applicant
I PERMIT NO. 5""-'107.-
ZONING (omce use)
1&76({J)~~
ILl
LEGAL DESCRIPTION (office use only)
LOT l..-BLOCKL-- ADDITION w,~ I?, ,/_,
I
~ I~FB--
W ,. Lwc..J 1. M~
OWNER
(Name)
(Address)
/~ 7rg/
6i1!:
PID -Z)-~..CA?1-o
f9 .s-z.) '-It-{ 7 - / '-I g I
(Phone)
'-
"
9(...1
BUILDER /J f) C'" , /I () /J..
(Company Name) ~UJ NO '''''"'': \- Y'-L~' '"":1
(Contact Name) ~ 0 €..L.- ,,L,,~~
(Address) /9 ~CJ A" ~blSiAJ /1,,(.
TYPE OZWO 0 New Construction ODeck OPorch ORe-Roofing
OAddition o Alteration OUtility Connection
O 0 Misc.
CODE: I.R.C. I.B.C.
Type of Constnlction:
Occupancy Group:
Division:
I hereby certifY that I have filrnished mformation on this application which is to the best of my knowlcdge true and correct. I also certifY that I am the owner or authol1zed agent for the
above-mcnltoned 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
otf1cial can revoke this permit for Just cause Furthermore, I hereby agree that the City otf1cial or a designee may enter upon the property to perform needed mspections.
X P~<gnature 2~0~a~!r's7ic~~O 9-~a~-()S-
I
A
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
B
(Phone)
(Phone)
LJ A-/:O,...J,I4-. PIAl
bl7, - f37~- "4-7
~ "" "g' '7
ORe-Siding DLower Level Finish
o Fireplace
I
E
II
F
I
III IV
H I
2 3
A
R
5
PROJECT COST/VALUE $
(excluding land)
B
S U
V
M
4
$
$
$
$
$
$
$
$
L~~_""
"14 'i~
Park Support Fee
#
$
$
$
$
$
$
$
$
$
I~.-
4-4....- -
I I '(')
MA-
SAC
#
Water Meter
Size 5/8"; I";
\ .?--.t::;
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
TOTAL DUE
--
-
Paid ....rV:>. -,
Date/l.l .2 / r
f(" ((17)
Receipt No.
By
'"
---------
ThiS IS to certifY th 're uest in the a~tlon and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
when signed by the City Planner "conslltutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a CertIficate ofOcclIpancy mllst 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
")R LAKE
.uN NOTICE
SCHEDULED
DATE TIME
/OP~S-
, ,
ADDRESS /6 /' ~ / Uh ; ~4/ L,e-,.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
s-- ~6 2.
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o ~CH FINAL /J
/~Y~.J P
, - .
o EXlGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
/2 / r }
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( C~/oS-e /-/k__ '\
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A'WORK SATISFACTORY, PROCt:.t:.u
o CORRECT ACTION AND PROCEED
o CORRECT WO~K',;,A~ FO~NSPECTION BEFORE COVERING
Inspector: YF~ ':;'w,ler/Contr:
, C7
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
lNSNOTl