HomeMy WebLinkAboutBldg Permit 05-0462
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and si~ at bottom)
ADDRESS
LEGAL DESCRIPTION (office use only)
LOT II BLOCK
ADDITION
OWNER
(Name)
I'1l9K-r/4
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
White File
Pink City
Yellow Applicant
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Date Rec' d
PERMITNOa--L(6~
ZONING (office use)
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PID
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(Phone)
7)'"2,- ~70"'?J 7 '/
TYPE OF WORK D New Construction DDeck DPorch lItiRe-Roofing bfRe-Siding DLower Level Finish 0 Fireplace
DAddition o Alteration DUtility Connd@n 'f'(,
CODE: OLR.C. OLB.C.
Type of Construction:
Occupancy Group: A B
Division:
(Phone)
(Phone)
o Misc.
I
E
III
H
2
B
S U
PROJECT COST IV ALUE
(excluding land)
. ---
$ ~.5 00-
ished mformation on this application which is to the best of my knowledge true and cOITect. I also certify that I am the owner or authonzed agent for the
above-mentIOned prope' a that all c uction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
p r t fo JUs Furthermore, I hereby agree that the CIty official or a designee may enter upon the property to perform needed mspectlOns.
r:. "7 .-
/ ~2 $ ._d )
x
/
pe~t Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
IV
I
3
V
M
4
A
R
5
II
F
1
Contractor's License No.
$
$
$
$
$
$
$
$
r::2~S-OtJ. ~
"7'-1- -; S-
/r;)-5
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
7~ -;
5r 2-3/':)
Building Otlicial
Date
Date
# $
# $
$
$
# $
# $
$
$
$ ~0~~
.---'
Receipt No. 1I>f1::J/
By ~
ThIS IS to certify that the request m the above application and accompanymg documents is in accordance with the City Zoning Ordinance and may procecd as requested. ThiS document
when signed by the City Planner conSl1tutes a temporary Certificate of Zonmg compliancc and allows construction to cnmmence. 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
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHEDULED ,fh:",{~/
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~~~~
ADDRESS
/~~?S~
OWNER
CONTR.
PHONE NO.
Cs-- {/'6'2
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP , /
o PLUMBING FINAL ~ I
o MECH FINAL
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~~NSPECTION
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
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/'Ii' ~~~~;; ACTION AND PROCEED
o CORRECT WO~K.;~L~ ~ REINSPECTION BEFORE COVERING
Inspector: ~/ ____ Owner/Contr:
II' ~
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
&
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl
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