HomeMy WebLinkAboutBldg Permit 05-0848
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ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 05"', 0 8~
3z oS f> (/1 I t:.-ICIJ VI Ct IL.
ZONING (office use)
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
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BUliDER ~.
(Company Name) L R. E \fLU J 1\' ^ (
(Contact Name). 0 (r<-. \-\t."A.. v\.. ~ ~
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TYPE OF WORK 0 New Construction DDeck OPorch he-Roofing
DAddition OAlteration OUtility Comfcti;n
OWNER
(N ame)
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(Address)
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(Address)
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
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(Phone)
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(Phone)
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ORe-Siding
OLower Level Finish
o Fireplace
o Misc.
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E
II
F
I
III IV V
HIM
234
A
R
5
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby certify tha I have
above-mentIOned pr erry a
official can revoke th permtt
m[s d mformation on this applicatIOn which is to the best of my knowledge true and correct. I also certify that I am the owner or authorized agent for the
tha 11 construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
JU use. Furthermore, I hereby agree that the Clry official or a designee may enter upon the property to perform needed mspec IOns.
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Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
Contractor's License No.
Date
$
$
$
$
$
$
$
$
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
7&~Vz}
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
7G,. L,L-
P.JI.Ctf
11
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Buildlllg Oflici,ll
Date
Th[s [s to certify that the request in the above applicanon and accompanying documents is in accordance with thc City loning Ordinance and may proceed as requested. Tins document
when signed by the City Planner constltutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of 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
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6ATE
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-SJ.,oS- fi~ Cl r
TIME
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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o FOOTING
o FOUNDATION
o FRAMING
o INSU~ON,....
~FINAL \,-on
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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Aft) Wtb.Q~
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-r40RK SATISFACTORY, PROCEED
~ ~ORRECT ACTION AND PROCEED
o CORR T K, CALL FOR REINSPECTION BEFORE COVERING
Inspect r:
Owner/Contr:
850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTl