HomeMy WebLinkAboutBldg Permit 05-0872
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ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/ ~ r; I!-/
Date Rec' d
White File
Pink City
Yellow Applicant
PERMIT NO. CJ5 - ?~d+
L LI/JA/S
, -/
Auf;,
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT /J.-m..,OCK I ADDITION P./tdJ'r../ ~ .
OWNER
(Name)
~~..... ~ IV r'''_
If, 1. h/l/C~
(Phone)
752-1'~?-~//r
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
PID t?/ (/}- C} I d-
(Phone)
(Phone)
TYPE OF WORK ~w Construction DDeck DPorch ~e-Roo;, /i~"5r;/1J /DLower Level Finish
DAddition DAlteration DUtility ConneA 'r/ti';!/~
CODE: DI.R.C. DI.B.C. 0 isc.
Type of Construction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
o Fireplace
PROJECT COST IV ALUE $
(excluding land)
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 authonzed agent for the
above-mentlOned property and that all construction wilI conform to all existmg state and local laws and wilI proceed in accordance with submitted plans. I am aware that the buildmg
:c~/ mIt for~hermore, I hereby agree that the CIty offiCIal or a deSIgnee may enter upon the propeny to pel form needo/7/ ()..... <." _
- ~ S1gnature Contractor's Ltcense No / OOe
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
.(;? 5W I
$= /4~?~ I
$ /,.~l7t
$ I
$ I
$ I
$ I
$
$
pplication Becomes Your Building Permit When Approved
~ 91'ft>
Buildlllg Otlicial Date
Park Support Fee
SAC
# $
# $
$
$
# $
# $
$
$
$ rll.i;---
.v- "If) ")..! _
Receipt No. g { /U (T)(:;)
By 0--- '
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
..........--
Paid
Date
'1ft;
~ q~q.>S
ThIS IS to certify that the request in the above applicallon and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. TIllS document
whcn signed by the City Planner constItutes a temporary Certificatc of Zonmg compliance and allows construction to commence. Before occupancy, a CertIficate of Occupancy must bc
issucd
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
. PRIOR LAKE
.."PECTION NOTICE
SCHEDULED
ADDRESS
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L)'o.H~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
DATE TIME
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r 'C
~--e
./
b-- 91;),
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
~ ~ULATION 0 SEWER HOOKUP
~~~AL 0 PLUMBING FINAL
o SITE INSPECTION ~ECH FINAL /'>
COMME~: ~~~f-- ~
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v /
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.~,;' L-1?~. 7J~~P(;~
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o EXIGRADlFllllNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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/ V
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT".J";to/ REINSPECT,ON BEFORE COVER'NG
Inspector: /'" P" c.,...r.,( _ /"'I'.VAer1Contr:
V'
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNon
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI