HomeMy WebLinkAboutBldg Permit 05-0465
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print IIJId sign at bottom)
I ADDRESS
~ '3 , q t3'1-lScLVI--\ S-\--. S W
Date Rec' d
.5 Zf.or
I. While File I PERMIT 0 I
2. Pink City N . OS. 0""-/- C
J y tllow Applicant , ,- (p .;.-1
I ZONlNG,_"" I
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID zG. '72...0/1.0
&=R:ren^'-i ,\At. Rc:> ~/~ ~
(Address) ~ 3[0( 6Q l~~ .5 t- s vu P n~ r ~(ct
(Phone) C<l52 ) ~l/o - I sy 8
fL1N 5:5"3/:>
BUILDER. .
(COmpanYName)~~l~ U,J,....,~\\h..V Qc. <::l ~ ""'-fl ~
(Contact Name) S"co++ ~"r.s-CI """-
(Address) \ '" AI.
TYPE OF WORK 0 New Construction o Deck o Porch ORe-Roofing
o Addition DAlteration OUtility Connection 0 Misc.
. CODE: DI.R.C. MI.B.C.
Type of CoJJStruction'r' I n ill IV V A B
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
(Phone(.lcDs) .sILl - V~ s-q
(Phone)("')~7,\ 22-q - Y VJ LY
OLower Level Finish 0 Fireplace
PROJECT COST /V ALUE
(excluding land)
s5cx::>C)
I bc:reby certifY tbatl have furnisbed information on tbis application wbicb is to the best of my knowledge true and correct. I also certify tbatl am tbe owner or authonzcd agent for the
above. ooed properlY. d that all construction will conform to all exislina state and locailaws and will proceed in accordance witb submitted plans. I am aware that tbe building
of'flcial coke this p it for just cause. Furthc:rmore. I bereby agree that the city official or a designee may enter upon the property to perform needed mspccti1s.
X -ZO~g,q((Jl{ S/?3/05
Signature Contractor's License No. Date
Permit Valuation
Pennit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Penult When Approved
Buildinll. Official
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; S
Pressure Reducer S
Sewer/Water Connection Fee # S
Water Tower Fee # S
Builder's Deposit $
Other $
TOTAL DUE $ 1't. 0 ()
11:5(7
I Paid
Date
I~i;;
7~'OV
. 2fc{-
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 requ''Sted. This dtlCUmt.'IIt
when signed by the City Planner constitutes a temporary Certilicate of Zoning compliance and allows construction to commence. Before occupancy. a C''rtiflCatc of Occupancy must be
issued
Plamting Director
Date Soecial Conditions. if any
24 hour notice for an inspections (~2) 447-9850. fax (~2) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
DATE TIME
CITY OF PRIOR LAKE 7,(p..or
INSPECTION NOTICE SCHEDULED
ADDRESS 33/f (]q/SCwt Sr-
OWNER CONTR.
PHONE NO. PERMIT NO. 5-Qr,r-
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION o SEWER HOOKUP o FIREPLACE FINAL
o FINAL o PLUMBING FINAL o GASLINE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS: ~rc!(~
WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND P ED
L
Owner/Contr:
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl