HomeMy WebLinkAboutBldg Permit 05-0971
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1.30..00'
White
Pink
Yellow
File
City
Applicant
(Please type or print and si~n at bottom)
ADDRESS
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LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(N ame)
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(Phone)
(Address)
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BUILDER
(Company Name) Rg.l^BLt- QuALi"R CQNSTRVG'f):)l's t:NC.
(Contact Name) ~R.1'\f "'S(..k.o1\f\~
(Address)
I PERMIT NO. tJ5. 097/
, ZONING (office use) ,
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(Phone) ~/~ ':). ~O
(Phone)
7~67
o Misc,
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m IV V
HIM
234
B
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PROJECT COST IV ALUE $
(excluding land)
A
R
5
II
F
I
$
$
$
$
$
$
$
$
Park Support Fee
SAC
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
[ hereby certify that I have furnished mt()rmation on this application which is to the best of my knowledge true and correct. I also certify 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 buildmg
:ncial can;;;;~it f~rmore, ~bY agree that the CIty official; ~d;:~;al ~t~ upon the property to perform needed qs~e;~~ O.s
Signature Contractor's License No. 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
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
71#.(//./
1.3tJ.or
Building Ofticia\
Date
# $
# $
$
$
# $
# $
$
$
$ 7(,.00
Receipt/}No. SlJb$' 4l-
BYr! ·
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 CertIficate llf Occupancy must be
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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CONTR.
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
COMMENTS:
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINA~ /
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u / J / A
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DATE TIME
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s- - 97/'
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~ORK SATIS
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REI PECTION BEFORE COVERING
Inspector:
/
t/ '
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
Owner/Co~"
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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