HomeMy WebLinkAboutBldg Permit 05-0578
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and si~ at bottom)
ADDRESS
/ fo<b 50
WILLow
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LEGAL DESCRIPTION (office use only)
LOT q BLOCK t/ ADDITION U/.../lf/JUJJ
,
OWNER
(Name)
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(Address)
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White
Pink
Yellow
File
City
Applicant
I PERMIT NO. (j5--t) 1 ff
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(Phone)
BUILDER
(Company Name)
(Contact Name)
(Address) /0 2. "2...
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(Phone)
(Phone)
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TYPE OF WORK 0 New Construction ODeck OPorch ~e-Roofing ORe-Siding
OAddition o Alteration OUtiJity Conn~n
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
c:f:
I
E
III IV
H I
2 3
V
M
4
ZONING (office use)
PID flll ~ -() 36
(95'4 'f'l()-'l400
t;/Z-g7S:-7?'17
,pn~- '27zj?'
OLower Level Finish 0 Fireplace
o Misc,
A
R
5
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby certify that I have furnished mformation on this appIicatlon 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-mentIOned properry and that all construction will conform to all extstmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official can revoke t rmit for Just cau thermore, I hereby agree that the Clry official or a designee may enter upon the property to perform needed mspectlOns.
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Signature
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
II
F
I
$
$
$
$
$
$
$
$
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This Application Becomes Your Building Permit When Approved
Building Otlicial
Date
203 SI} z,~
Contractor's License No,
Park Support Fee
SAC
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid
Date
--"
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Date
#
#
$
$
$
$
$
$
$
$
$ 1)&"
Receipt No.i/;J ,1 l
By ~..
~
#
#
ThiS IS to certify that the request in the above application and accompanymg 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 Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
Date Special Conditions, if any
24 hour'notiee for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
DATE TIME
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
O~ ~LATION
..,...lf1=INAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
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o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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~TISFA(;'IUKI. t'KUI.,;t:::i:D
o CORRECT ACTION AND PROCEED
o CORRECT WO~K..;A~R 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!
INSliOTI