HomeMy WebLinkAboutBldg Permit 05-0760
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
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Date Rec' d
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I PERMIT NO.05--1fdJ
File
City
Applicant
ZONING (office use)
J?-;)J
LEGAL DESCRIPTION (office use only)
LOT ;LaLOCK a ADDITION sch Y)1C) I.:! e, / 5
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OWNER
(Name)
~filt/t ry'
4q3""3
(Address)
BUILDER L1
(Company Namet,LII(
(Contact Name)
(Address)
Pro C03 -() 07
(Phone)
0<2 ~7-1[(t/~
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(Phone) 7(5 L/92
(Phone)
c;c;e7
.
TYPE OF WORK 0 New Construction ODeck OPorch 7JRe-ROofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Conne~
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
III IV V
HIM
234
A
R
5
I
E
II
F
I
o Misc.
B
S U
PROJECT COST IV ALUE
(excluding land)
$
I hereby certifY that I have hlrnished mformal1on on this application which is to the best of my knowledge true and conecl. I also certifY that I am the owner or authonzed agent for the
above-menl1oned property and that all cjlnstruction will conform to all extstmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
ollinal can revoke thIS permIt for Just c'!lise Furthermore, I hereby agree that the CIty official or a designee may enter upon the property to perform needed mspectlOns.
X .~~~ '/1J32"55L1t:? 0-5-~5
/ Signature ' . Contractor's License No. Date
Permit Valuation :2 ,"'j()IJ.
Permit Fee $ 74-- -'5
Plan Check Fee $ /,-?6
State Surcharge $ I
Penalty $ I
Plumbing Permit Fee $ I
Mechanical Permit Fee $ I
Sewer & Water Permit Fee $ I
Gas Fireplace Permit Fee $ I
This Application Becomes Your Building Permit When Approved
8uildlllg Oftieial
Dale
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
7~ .----
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid
Date
/', -----
--- (&? .
f1-~-5
Receipt No. l/6f'I7Gft-,
By OL..: /
o
ThiS IS to eertitY that the request in the above applicatIOn and aceompanYlOg 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 Certiticate of Zonmg compliance and allows construction to commence. Before occupancy, a CertIficate of Occupancy 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
DATE
~~S
~'T0;/ ~~~JCT~ cST
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FlJlNAL
9j'ECH FINAL
~_yOO
COMMENTS:
TIME
os-- ?6CJ
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
A /1
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~K SATISFACTORY, PROCEl::O
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CAL~ FJ' REINSPECTION BEFORE COVERING
Inspector: ~~er/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!