HomeMy WebLinkAboutBldg Permit 05-0561
(Please type or print and siltll at bottom)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(p. / IR .Or
~i~~e ~:~y I PERMIT NO. (), ~ 0' z-7_ /
Yellow Applicant .....,. ~ CP
/5/70 6l-lb/V u,c....
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name) 1) nY\)f\\ '()
(Address)
'V ...R:-1f<.{, ".>o,v
(Phone)
BUILDER
(Company Name) 6000 '+-o &0
(Contact Name)~\ \<.~ l-U:~l\~
(Address) lO C:f^-j>t.f It.. Ac-6eM
~~s-\ I-.A..(,..\(~e .-v
(Phone)
(Phone)
(A ~v ;Ile
'l"~('L
TYPE OF WORK 0 New Construction DDeck DPorch lQie-Roofmg ORe-Siding
DAddition DAlteration DUtility Conne~n p/l1!:1J tfl",
o Misc.
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group:
Division:
A
I ZONING (office use)
MfO
PIDZS: /&5. 0+3_ 0
q s-2-cf'to -fJ,=> 10
(0 /'2.. - 3'1Jl- <'08'79
c;'s-~ 'IP
DLower Level Finish
B
I
E
B
S U
PROJECT COST IV ALUE $
(excluding land)
II
F
1
III IV
H I
2 3
V
M
4
A
R
5
o Fireplace
I hereby certify that I have furnished mformation on this application which is to the best of my knowledge true and correcl. I also certify that I am the owner or authotlzed agent for the
above-mentlOned property and that all constructio . 1 conform to all existIng state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official can revoke this perml! for Just caUSe er re, I hereby agree that the City official or a designee may enter upon the property to perform needed mspecltons.
X ~"L ~ -/6 -or
/ ~gn\lture 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
$
$
$
$
$
$
$
$
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
This Application Becomes Your Building Permit When Approved
Paid
Date
'IrR..vv
c,~/ {:;A7d"
Buildtlljl. OIlicial
Date
# $
# $
$
$
# $
# $
$
$
$ "7~. (IV
Receipt Np. #771--
By A
0--
ThIS tS 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. Thts document
when signed by the City Planner constttutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certtftcate 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
ADDRESS
/ S/ /6
DATE TIME
SCHEDULED 6'pds-
~~'1- C r
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
PHONE NO.
CONTR.
PERMIT NO. ~- ~,/'
o FOOTING
o FOUNDA liON
o FRAMING
~~TION
o SITE INSPECTION
COMMENTS:
o PLUMBING RI 0 EXIGRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLINE AIR TST
~;:: ~ 444/}-
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~.. ~ q//~/S' rc
~~' ~ O/O<<P~
/ /
KWORK SATISFACTORY, PROCEED
~ ~ORRECT ACTION AND PROCEED
o CORRECT WORK CAL 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