HomeMy WebLinkAboutBldg Permit 05-0441
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and si~ at bottom)
ADDRESS
~3/}9
OWNER
(Name)
White
Pink
Yellow
Date Rec' d
File
City
Applicant
I PERMIT NO. CJS - If tj ~
I3w-okuK/
F/'ebt L
(Address)
53/7
13/?"'~~S (! l'r
LEGAL DESCRIPTION (office use only)
LOT ~LOCK S ADDITIONIJ/ltJt)~ 11c
Sco1l-
BUILDER
(Company Name)
(Contact Name)
(Address)
Uti&LJ
(Phone)
S_t= .
(Phone)
(Phone)
o New Construction ODeck OPorch ~~e-ROOfing
OAddition OAlteration DUtility connefti~
o Misc.
TYPE OF WORK
CODE: OI.R.C. OLB.C.
Type of Construction:
Occupancy Group:
Division:
A
B
I
E
II
F
1
A
R
5
ZONING (office use) ,
PID O::LI-IJ IL/-I'.L
9'52- 4/4/0"' 7?..3~
ORe-Siding OLower Level Finish
B
S U
PROJECT COST IV ALUE $
(excluding land)
o Fireplace
I hereby certify that I have filmlshed mformation on this application which is to the best of my knowledge true and conect. I also cenify that I am the owner or authonzed agent for the
above-mentlOned 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
official can revoke this permit fOJllust cause rthermore, hereby agree that the City official or a designee may enter upon the property to perform needed mspecl1ons.
X _~- ~ E)- 17- OS-
Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
III IV
H I
2 3
V
M
4
$
$
$
$
$
$
$
$
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I
I
This Application Becomes Your Building Permit When Approved
Building Ollicial
Date
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
Paid
Date
---
-jta.
-,:; - / '1 ~ S
#
#
#
#
Receipt No.
By
$
$
$
$
$
$
$
$
$7b,---
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c.-'
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ThIS IS to certify that the request in the above applical10n and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner conSl1lutes 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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
S-..J' 79 .?oo k
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.,.A:rFINAL
o SITE INSPECTION
COMMENTS:
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL /J
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DATE TIME
~~~r
~y
OS"--w/
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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~ SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL R REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl