HomeMy WebLinkAboutBldg Permit 05-0400
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
White
Pink
Yellow
File
City
Applicant
PERMIT NO. OS, 0+00
(Please type or print and sign at bottom)
ADDRESS
/I1//!l~ b t~ 1)
51-.59
01<-
LEGAL DESCRIPTION (office use only)
Date Rec' d
5. tr ,{lJ
ZONING (office use)
Pl/tJ
LOT
ADDITION
PID e.5: 2./~ t/~8. 0
BLOCK
OWNER
(Name)
(Phone)
((j5' z) '102 -()35t!
\.. ~
IOvO
S-r tilt,
545Cf AMBLtf,lOO I)
t&;u ~O~l'\/? I biUQ#ELI>vt?
(Contact Name) ".)o6-L ,Ii!o~
/() 2 Z- HeA-Of} hI
(Address)
{)~i
(Phone)
(Phone)
(f5'2-) i.(6~' z ? zg
6/2 - 'i57};~77 ~/
C;-5"'> 2 L
BUILDER
(Company Name)
r.~\;; ~,.v e:: "' HAl'
......- ./ /
TYPE OF WORK 0 New Construction ODeck OPorch ~.Roofing ORe-Siding
OAddition OAlteration OUtility Con(ction
CODE: OI.R.C. OI.B.C. 0 Mise.
Type of Construction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
(Address)
r-'~
"? ( .
OLower Level Finish
PROJECT COST IV ALUE $
(excluding land)
o Fireplace
I hereby certifY that I have furnished mformation on this application which is to the best of my knowledge true and correct. I also cel1ifY that I am the owner or authonzed agent for the
above-mentIOned propel1y and that all construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
officral can revoke thIS permIt for Just cause Furthermore, I hereby agree that the CIty offiCIal or a deSIgnee may enter upon the property to perform needed m~pectIons
X r ---?-/'~ - 5~-~tJ 57
~-/ - Stgnature Contractor's Ltcense No / - Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
TOTAL DUE
$
$
$
$
$
$
$
$
$ 7~.vU
This Application Becomes Your Building Permit When Approved
7(" ,lj
5't It " J-
ReC~iPt ~ 6TY/77
By ./
./.i -
Paid
Date
Building Ollicial
Date
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 constltutcs a temporary Certificate of Zon1llg 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
DATE TIME
-!>>~.J
St(s-y ~b'/e~ood
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
D. PLUMBING FINlJAL .
~CH FINAL/
/C-~ /t10
CJs- ~C()
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
/} / . r'
/1 t'JU r--e ---S J A 00-1 .-2. 'Ol.A.>_ <\.
~ 2re )t/Qp., 40 r<< ;7?6......
f?/A /'/0 &4. ~ ;I-- 4&it' k ~ ,dt;.'u..r~
/
/'l
1/ jJ_ /"
/'-f.Jo · q ~/Y?er'S O/C
r,~~ ~ 9YOUPf.- <L
V
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL F REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!