HomeMy WebLinkAboutBldg Permit 05-0466
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE. .
AND lJ I u...ITY CONNECTION PERMIT
Date Rec'd
~ . 2-- tf: 0;-
I. While Fit. I PERMIT I
2. Pink City NO. 05- () 460
3 Y oIlow Applico..
(Please tv1Ie or orint lIDd sian at bottom)
ADDRESS
q \, \ Co.. -\.-eS S-\-. 5 E-
LOT
BLOCK
LEGAL DESCRu uON (office use only)
ADDITION
OWNER.
(Name)
(Y\. -\. \~ l\J a \Q r"'\
L\ \." (' })-\.p') >+. <; €'
(Address)
ZONING (office use)
PID2- S- .{ 83 . 6 13. 0
P('l()r L~ \~
(Phonel 0(5'(.) ~'4." -S4\tao
MN '5'S3/c.
Bun.DER
(Company Name) (\ 411\.o<-\}1,.ru"' \..U l,.^4:'k~ G:> . Cli. +:- ~ l ~
(Contact Name) <':;Ct\4--\- ?l~~(J A .
(Address) 5\00 \.1l~ "\ ItoQ tV s;-'^-"~_ R
A
(phone) (,(0 ~ \._,..., \.l- "2-0~"""'f
(Phone("'<O~) 2~G - L[folV
~ v'V\ "-' . C:;;S-- '--l "l.k'"
OLower Level Finish
B
I
E
PROJECT COST /V ALUE
(excluding land)
o Fireplace
$ ~"?O~
I bereby certify tbat I have furnisbed information on tbis application wbicb is to tbe best of my knowledge true and w...... I also certify tbat I am tbe owner or authorized agent for the
above. oned .......} 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 building
;lcial c evoke this p . for just cause. Furthermore. I hereby agree that the city otr~; ~~ \; ~t?pon the .,.. " ,; to .,.:i..... n~ti::;:~%.r-
Signature Contractor's License No. . Date
f\.)-e.u."
I
TYPE OF WORK 0 New Construction o Deck OPorch o Re.Rooling ~Re.Siding
OAddition OAlteration OUtility Connection 0 Misc. .,...
. CODE: OJ.R.C. ~I.B.C.
Type of Construction:
Occupancy Group:
Division:
. Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
II
F
1
ill IV V A B
HI MRSU
2 3 4 5
$
S
$
$
S
S
S
S
I Park Support Fee
I SAC
I Water Meter Size 5/S"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
I Paid
I Date
?'~",LV
f. z. 0/. OJ
This Application Becomes Your Buildlnl Permit When Approved
Buildinl!. Official
Dale
# . $
# S
$
$
# S
# S
$
$
$ 'l~ A) 0
Receipt No. 9f:tl/
Bv .J<
(/
TIus IS to certify tbattbe request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requL'Stcd. This documt'llt
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and aUows construction to commence. Before occupancy, a CL'I1iflCate of Occupancy must be
issued
Planning 1::' .....
Date Special Conditions, if any
24 hour notice for all inspections (9!12) 447-98!1O. fax (~2) 447-424!1
16200 Eagle Creek Avenue Prior Lake. MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED
G-~'~
ADDRESS
Lt lr;(
/" a L.~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
S-II&~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
5' id/\l\t:..
r~~
----
~
/' / /
I (~(P(_
~ --
'---
-----
-- "'"
r~r~
t tiC )
~
------
o WORK SATISFACTORY, PROCEED
o CORRECT A~TION AND OCEED
o CORRECT WO, FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
.
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH cl SAFETY!
'_aT'