HomeMy WebLinkAboutBldg Permit 05-0670
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
7. Is. os-
White
Pink
3 Yel\ow
File
City
Applicant
I PERMIT NO. Os. 0 &70 I
(Please type or print and sil!;n at bottom)
ADDRESS ,/ u//. I
//7 /"TV #,,/IO,,V'
Lql1 e
5 '--vi"
/? :'0 r- j~i A ~
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PIDZ-s-. 2+e. 035.0
OWNER
(Name)
/t/c1c/ k/'/7~t?(l/
/
(Phone)
1'5;?-ddh'- 54/'5'3
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
DAddition DAlteration DUtility Connection
CODE: ~I.R.C. DI.B.c.
Type of ~nstrnction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
~Re-Siding OLower Level Finish
o Fireplace
o Misc,
PROJECT COST IV ALUE $
(excluding land)
I hereby certify that I have furnished mformat; 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-menl1oned property and that all eo etion will conform to all existmg state and local laws and will proceed in accordance with sub mitt cd plans. 1 am aware that the buildmg
official can revoke this permll for Just e, Lhermore, I hereby agree that the City official or a designee may enter upon the property to perform necded mspections.
X - / ~<--. //j'5~S
L ~nature -- Contractor's License No, "bate 1
Permit Valuation I Park Support Fee # $
Permit Fee $ I SAC # $
Plan Check Fee $ I Water Meter Size 5/8"; I"; $
State Surcharge $ I Pressure Reducer $
Penalty $ I Sewer/Water Connection Fee # $
Plumbing Permit Fee $ I Water Tower Fee # $
Mechanical Permit Fee $ I Builder's Deposit $
Sewer & Water Permit Fee $ I Other $
Gas Fireplace Permit Fee $ l TOTAL DUE $ 767. 0 d
This Application Becomes Your Building Permit When Approved Paid 7& . 0 0 Recei~o, 49@(j/
~~ 4~/oS; Date 7. 1:1. 05 By .
()
Building Oftic(;ll ome
ThiS IS to certify that the request 111 the above applical10n and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested, Tlll~
when signed by the City Planner consl1tutes a temporary Certificate of Zoning compliance and allows construction to commence, Before occupancy, a Certificate of Occupal
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
SCHEDULED
DATE TIME
J:4:A J
'1 /
ADDRESS
/?9'i/() tu//4~ kr1~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
,.-er=FiNAL
o SITE INSPECTION
COMMENTS:
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
O>>H FIN~L /
/~6 / de
6S-- -670
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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~ORKS~ACTORy.PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~~~~OR REINSPECTION BEFORE COVERING
Inspector: ~ ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl