HomeMy WebLinkAboutBldg Permit 05-0496
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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File
City
Applicant
(Please type or print and sign at bottom)
ADDRESS
~ ax;cd' :J/~
6' /!/5'
LEGAL DESCRIPTION (office use only) 0
LO'("1 BLOCK ,~ADDITION A/~
- ,- /-
,
{) 17nZ-
{;
(2)vd PIDOZ6S- 053
OWNER
(Name)
'~O.4?-C</ a ~Ad___
'( / / ~~
.5'"7 /S- ,t3./~ood ,;~,4/6
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
PERMIT NO.
CJ5'-LfQIi
ZONING (office use)
9 s.2 - '/()~ -cxo .J.e,~
TYPE OF WORK D New Construction ODeck OPorch ~-ROOfing ORe-Siding OLower Level Finish D Fireplace
OAddition OAlteration OUtility Connection
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
o Misc,
B
S U
V
M
4
A
R
5
III IV
H I
2 3
I
E
II
F
1
PROJECT COST /V ALUE
(excluding land)
$
I hereby certify that I have htrnished mformation on this applicallon 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-menlloned property and that all construction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
:fiClal can revok~~or Qau~r::ree that the CIty offiClal or a deSIgnee may enter upon the property to pel form needed~;~ kS-
~ / /SlgnatUre Contractor's License No / Dat,(
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"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
,......., F _____
'l(f?'- -
, ~ -- d-/}-- !:J
Paid
Date
Building Ofticial
Date
# $
# $
$
$
# $
# $
I $
I $
I $
~ /C / / / /)
Receipt No.L..I' 0 r <0-'
By 0'
~
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 temporary Certificate of Zoning compliancc 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
DATE
(,~;;S-
r ,
g,/C-'~OO/ 4Q,
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
,-:.S-7/S'
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o "H FINAL ~
~rro"
COMMENTS:
TIME
oS- - ~9~
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
01 /7 /
~O r 'l"/de9;'S 6 ~
.~.J-L. ,.~ a.-/ov~
/ ~ I/" ..,
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.hORK SATISFACTORY. PROCEED
I ~ CORRECT ACTION AND PROCEED
a CORRECT WOR~;,%~EINSPECTION BEFORE COVERING
Inspector: f ~/""" Owner/Contr:
CALL 44;.9850 ~HE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY!
INS/IIOTl