HomeMy WebLinkAboutBldg Permit 05-0545
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
~~ /3. 05
File
City
Applicant
I PERMIT NO. 05054-5'
White
Pink
Yellow
(Please type or print and si~ at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
ZONING (office use)
et
LOT
ADDITION
PID z.s: 007.008,0
BLOCK
OWNER
(Name)
(Phone)
I (Address)
BUILDER
(Company Name) /1 ~ r CO ~I ~ f' :7:::.6-) C--,
(Contact Name) t. e."I L/ f( lrO e('-/ ~ V
(Address) i~.5 3-s- T ~t.ft'A d: f; "7\ _. c: ,-:- 5C
( ... II'
'Y <(7- I.? -~
o
(Phone)
~ '. (Phone)
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TYPE OF WORK D New Construction DDeck DPorch DRe-ROOfingVi~e-Siding
OAddition DAlteration DUtility Connection r
DLower Level Finish
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
DMisc.
V
M
4
A
R
5
I
E
II
F
I
III
H
2
IV
I
3
B
S
U
PROJECT COST IV ALUE
(excluding land)
D Fireplace
$
I hereby certify that ( have furnished mformation on this application which is to the best of my knowledge true and conect. I also certify that I am the owner or authOrIzed agent for the
above.menl1oned property and th 11 c struction will conform to all exisl1ng state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
Officia:;z:e this permit r JUS ca Furthermore, I hereby agree that the Clly official or a designee may enter upon the property to perform needed mspectlOns
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Signature - Contractor's License No. ' Date
'7&~O(J
,
Receip~9.~ HJ(P ~/
By ~__
Permit Valuation
Park Support Fee
SAC
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
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
'lr,~oo
V ,,1:1.. () J-
Paid
Date
Buildlllg Onicial
Date
#
#
#
#
$
$
$
$
$
$
$
$
$
ThIS IS to certifY that the request In the above applical10n 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 Zoning compliance and allows construction to commence. Before occupancy, a Certificate 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
"];-~fTIME
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/h6/'CJ
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
..A:f'<<NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBIN~FI L
. 3}"ECH FI~AL
~eSI e..
COMMENTS:
r" S-- - ~ 9",,)' ~
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FO NSPECTION BEFORE COVERING
Inspector:
OWner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!