HomeMy WebLinkAboutBldg Permit 05-0641
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ADDRESS
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1_ White
2. Pink
3 Yel\ow
File
Cily
Applicant
PERMIT NO'a-G". o(P4--1
ZONING (office use)
te.Z.SQ
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
PID 25. 183 .004-.0
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OWNER
(Name)
(Address)
(Phone) {L(, '2-,&lC/;] J L~_L
BUILDER ~ c;. [. Jl..-
(Company Name) n
(Contact Name) ail "v .
(Address) utoa t!~ -e(/,f 0(1
(Phone)
(Phone)
,
TYPE OF WORK 0 New Construction ODeck OPorch ~e,Roofing ORe-Siding OLower Level Finish 0 Fireplace
DAddition OAlteration DUtility Connection D Misc.
CODE: DI.R.C. DI.B.c. PROJECT COST/VALUE $ fi;ZD 0
Type of Construction: I II III IV V A B (excluding land)
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5
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I hereby certify that I have furnished mformation on 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.mentlOned property and that all construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official can r voke this per it for Just cause F1l11hermore, I hereby agree that the CIty official or a designee may enter upon the property to perform needed mspectlOns.
JOt(; 0 7-/"(;
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~. ~ 0
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 Pennit When Approved
Paid
Date
/v.()D
7- .7 AJY
4-97JO
Buildlllg Ollicial
Date
I~O
ThIS IS to certify that the request in the above applicatIon and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constItutes a temporaty Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certtficate 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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t'RIOR LAKE
. C:CTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
~ ~CH FINAL /)
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COMMENTS:
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o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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o WORK SATISFACTORY, PROCEED
o ~ ACTION AND PROCEED
/ CORRECT WORK, CALL FOR INSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
"
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
/NSNOTJ
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY I