HomeMy WebLinkAboutBldg Permit 05-0751
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
White File
Pink City
Yellow Applicant
I PERMIT NO. ()5 -~7I1
,
(Please type or print and si~ at bottom)
ADDRESS
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ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT Jd.:eLOCK I ADDITION ~ - hlUl-
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PID 001- 0/3
X OWNER
,/, (Name)
(Address)
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_((PhOne) 9s- -2-~?'t7. 7~17
l BUILDER .4 /" A ~ Af
(Company Name>pv/V-f/~-/.F' /Cdt1?/~A.--:!; /.P
(Contact Name) ~AP//_~4A'~(,d.-z../ -
. ,(Address)
t
(Phone)
Phone)~-~tP/-YC9~~
TYPE OF WORK 0 New Construction ODeck OPorch ~Re-Roofing
OAddition OAlteration OUtility Connet1i~
o Mise.
ORe-Siding OLower Level Finish
o Fireplace
CODE: DI.R.c. DI.B.c.
Type of Construction:
Occupancy Group:
Division:
A
B
I
E
II
F
1
III
H
2
IV
I
3
V
M
4
A
R
5
B
S U
PROJECT COST IV ALUE $
(excluding land)
Signature
,--
r n which is to the best of my knowledge true and correct. I also certlIY that I am the owner or authorIzed agent for the
rm to all existmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
hereby agree that the CIty official or a designee may enter upon the property to perform needed mspeetlOns
y-- ~-d'S:
Contractor's License No. Date ~
I'
x
Permit Valuation ,;;1\5""" C/O I Park Support Fee # $ 1
Permit Fee $ 7t/~ '/"71 SAC # $ I
Plan Check Fee $ /.. 851 Water Meter Size 5/8"; I"; $ I
State Surcharge $ I Pressure Reducer $ I
Penalty $ I Sewer/Water Connection Fee # $ I
Plumbing Permit Fee $ 1 Water Tower Fee # $ I
Mechanical Permit Fee $ Builder's Deposit $ I
Sewer & Water Permit Fee $ Other $ I
.....
Gas Fireplace Permit Fee $ TOTAL DUE $ /0, - --1
o..5"W.- --- n-tOc
This Application Becomes Your Building Permit When Approved Paid Receipt No. U J
Date 7- tI-C) By g.
Buildl1lg Otllcial Date
ThIs IS to eertiIY that the request in the above applicatIon and accompanying documents is m accordance with the City Zoning Ordinance and may proceed as requested. ThIs document
when signed by the City Planner constItutes a temporary Certificate of Zoning complIance and allows construction to commence. Before occupancy. a Certlficate 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
DATE TIME
SCHEDULED ~~-
~n&~ ///
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
~6~7
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
___-ii3 JlnfAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~ECH FINAL ()
/4?/'~r-
COMMENTS:
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/~CJ ~ C-?P'/J~~ys.
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o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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o CORRECT ACTION AND PROCEED
o CORRECT WORK~7 )'"'NSPECTION BEFORE COVERING
Inspector: /' ~ Owner/Contr:
CALL 447.9850 FOl-rHE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI