HomeMy WebLinkAboutBldg Permit 05-0562
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERut4.CATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(p, / (,. tiS-
I. While Fil. I PERMIT 0 ? I
~. :oltw ~:Iicant N . 0 -s:: () S7P '-1
(Please type or print and siJPl at bottom)
ADDRESS
l\ 13q,,\ E(,,^ C,fcie 5t
L-Cl~ ! M tJ
553/~
ZONING (office use)
~(If(
LOT
BLOCK
LEGAL DESCRu: uON (office use only)
ADDITION
OWNER
(Name)
(Address)
II ~r\c..ol€ I
y ~ql{ ~r;~
-J ~ ~ ( f\ eO. LJ
c,tcle.. Sf
PID z.S"". c) 17 .Of f_ 0
(Phone) q ~~- 4 ~ 1" 11;,1
t q k:Q. , M rJ 55 ~I 2.
,
D~\Jelo~~Q^t, lnC (phone) (qtj'JJ- ~3q- 404~
. . (Phone) ( Gj S1 ) - ~ ~~ - tt 0 q 1-
Of. ~ d..~~ M~V\f\-t~v'\~4, M-tJ ~ 530 ')
p\ \ o(
I BUll.DER II \ .
(Company Name) IV 0 ( ~ V\ 0 ~ K.5
(Contact Name) -:) Oe. f= O~)(
(Address) 13 0 ~ ~ /e'J ~.ca.J 4le
TYPE OF WORK. 0 New Construction ODeck OPorch \.r;e.Roofing ORe.Siding OLower Level Finish
OAddition OAlteration OUtility Conne~ 0 Misc.
. CODE: OJ.R.C. OJ.B.C.
TypeofCo~on: I
Occupancy Group: A B E
Division:
o Fireplace
I,S 11
I
II mIVVAB
F HJ MRSU
1 :z 3 4 S
PROJECT COST/VALUE $
(excluding land)
I hereby certify Ihal I have furnished informalion on Ihis application which is 10 lhe besl of my knowledge lrUe and ........ I also certify lhal I am Ihe OwnlT Of aUlhorizl'd agcnl fOf Ihe
.............. ,,", ""V ... ... .. '~tructio wil form to all existinc state and .Iocal Jaws .and will proceed in accordance wilh submilled plans. I am aw. arc lhallhe building
;C1al ca;YJ;;(JiS permvrtust cau . .1 hereby agree lhat the CI~ ~~ or ~ de;~e31enl u~ ~eir-"" 10 pmorm neGcd~niqo:5. 0 S
F Si~ Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
S
$
$
S
S
S
S
$
I Park Support Fee
I SAC
I WaterMeter SizeS/S"; I";
Pressure Reducer
Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
Other
TOTAL DUE
This Application B. . . .. s Your Buildin& Permit When A., _,. ,ld
I Paid //1I?V
I Date c.- / /7-P r
Buildinll Official
Dale
# $
# $
$
S
# $
# $
S
$
-
$ ,/& ~t'tJ
ReceiPt No. , 'l.J'7 J
By ..d,
?/ 1
ThIS is to certify Ihallhc requesl in Ihe above applicalion and accompanying documenlS is in accordance with Ihe Ci~ Zoning Ordinance and may proceed as requL'Slcd. This documenl
when signed by Ihe Ci~ Planner conslilutes a temporary Certificale of Zoning compliance and allows conslrUClion to commence. Before occupancy, a CLTlifu:ale of Occupancy mUSI be
issued
Plamting Director
Date Special Conditions, if any
24 hour notice for alllnspectlonl (9!12) 447.98!1O. fax (9!l2) 447424!1
16200 Eagle Creek Avenue Prior Lake. MN 55372
SCHEDULED ;~ r "'"
C;- I.Icf7lf
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
~/~
OWNER
PHONE NO.
CONTR.
PERMIT NO. ~,S'" - )~2
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
..Ja...FfNAL 0 PLUMBING FINAL
"5 SITE INSPECTION -"CH FINAL ()
COMMENTS~ /~ /Z'cr r
~r49~ 6~{r/
1/ /
// Ii
7fT
rr/t} /nt
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
4" /J pl'e." /" .S"
/ ~/
TH,~
-~
~
/
q ,.rC)(.)'t d
V
~ ~/ J/: / /
/ {'/~ //?~
~K~SFAC~~
o CORRECT ACTION AND PROCEED
o CORRECT WOR~K, ~;.~REINSPECTION BEFORE COVERING
Inspector: r< O'......erIContr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI