HomeMy WebLinkAboutBldg Permit 05-0681
(Please tyve or print and si~n at bottom)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
7. IS 05
1_ White
2 Pink
3 YeHow
, PERMIT NO. ()S 0 CO 8/
File
City
Applicant
F/Z6/"J 011/ T
ZONING (office use)
331-1--
sr:
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
PID 25. 24-9. 0$7 ()
OWNER
(Name)
(Address)
BUILDER
(Company Name) r. (l . e
(Contact Name) Cu f( t 5
(Address) 'f'l.. n E:,
(Phone)
r.A ,.r~lIL-C) ,L-i
t ~ (1.,,- &] V d. 9oz,7.--T
(Phone)
(Phone)
S-'rY\ ~ ( ,-..( L
LA rf t-
TYPE OF WORK 0 New Construction ODeck OPorch ~ie-ROOfing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtiJity Conn~~
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
o Misc.
I
E
1lI1V
H I
2 3
PROJECT COST IV ALUE $
(excluding land)
V
M
4
A
R
5
II
F
1
B
S U
rn hed 1Oformation on this application which is to the best of my knowledge true and COlTect. I also certify that J am the owner or authOrIzed agcnt ft)r the
t all co ...,~;O;l conform to all existmg state and local laws and will proceed in accordancc with submittcd plans. I am aware that the buildmg
rmit ~ Just se FlIlthermore, hereby agree that the CIty official or a designee may enter upon the property to perform needed 1OspectlOns.
-A-7..- () /()
x
'----'
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
Signature
Contractor's License No.
Date
# $
# $
$
$
# $
# $
$
$
$ 7?,oo
Receipt No. H8d?
By ...t.
0
$
$
$
$
$
$
$
$
Park Support Fee
SAC
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
'1&.0 C)
7. /5. a!!)
Building Otllcial
Date
ThIS IS to certify that the request 10 the above applicatlOn and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as rcquestcd. ThiS document
when signed by the City Planner COI1Sl1tlllCS a temporary Certificate of Zoning compliance and allows construction to commence. Bcfore occupancy, a Certlficatc 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
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS '3'3 4<'{
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
DIN.. SULA TJQN I-
PiNAL '<001
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED 7}20} tf'>
h-~ St-
CONTR.
PERMIT NO.
s- - (,8/
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
tVD ~~ iL\r~<:, ~
---
~ORK SATISFACTORY, PROCEED
o CORRE CTION AND PROCEED
o CORR CT ""m' CALL FOR REINSPECTION BEFORE COVERING
Inspecto : I ~) Owner/Contr:
7- 5~R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
UIREMENTS A.RE FOR YOUR PERSONAL HEALTH & SAFETY!
INSIfOTI