HomeMy WebLinkAboutBldg Permit 05-0886
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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White file
Pink City
Yellow Applicant
PERMIT NO. {)S. o,B~
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TYPE OF WORK 0 New Construction ODeck OPorch )j'Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition o Alteration OUtility Conrttion
CODE: OI.R.C. OI.B.C. 0 Misc,
Type of Construction: I II III IV V A B
Occupancy Group: A. B E F HIM R S U
Division: r \ 1 2 3 4 5
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I hereby certify ha Ir ished in ormation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authoflzed agent for the
above-mentIOned an hat all -onstruction will conform to all eXlsl1ng state and local laws and will proceed in accordance with submitted plans, I a aware th the buildmg
'x'fficial can revoke thl It r t ause Furthelmore, I hereby agree that the City official or a deSignee may enter upon the property to pel form needI.W /!"/ ,/7
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a~ Contractor's LIcense No te
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(Please type or print and sign at bottom)
ADDRESS
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JJ
III 73 JUI'/MJb
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
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/ OG1-rJ~YS C/ ^ (', ( ),0 r ~
RAJ. - _5c::"/1 :J;' h ,.,.<;...f. (/'/--\ "
l' (:' <:,? / XC'. r- X (' ~,: 4Vr.o> /'..J.
(Phone)
(Phon~)
ftbL/;, ./V.;/~; If'
ZONING (office use)
,Jeff j)
PID Zf"": 17/-. off; 0
(,-/[ ....103 -o'R~(
PROJECT COST IV ALUE $
(excluding land)
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
I Park Support Fee
I SAC
I WaterMeter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I
$
$
$
$
$
$
Builder's Deposit
Other
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
TOTAL DUE
This Application Becomes Your Building Pennit When Approved
Paid
Date
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Building Otlicial
Date
#
$
$
$
$
$
$
$
$
$ 7(,.nJ
#
#
#
?/ec.e' , No.
By .
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ThiS IS to certify that the request in the above application and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested, ThiS document
when signed by the City Planner constitutes a temporary Certificate of Zomng 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
ADDRESS
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DATE TIME
SCHEDULED .9~~.s-
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S~~~Je Ae..
. ..AKE
.uN NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o JjCH FINAL /J
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o EXlGRAD/FILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
o FOOTING
o FOUNDA rlON
o FRAMING
o INSULATION
,.0 rlrlAL
o SITE INSPECTION
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~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~.4~rR 5NSPECTION BEFORE COVERING
Inspector: /' ~~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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