HomeMy WebLinkAboutBldg Permit 05-0360
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
ADDRESS
I 11 "!.- L/-
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Date Rec' d
I White
2. Pink
3 Yellow
I PERMIT NO. ()S- - tJ 5 t cJ I
File
City
Applicant
ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(N ame)
k...v
(Address)
BUILDER
(Company Name )_p 1..1.S" c~) {) c-.s. · '8'1A-.. Rt-V: l '"
(Contact Name) 9 C vAA 5 t!J I$- t'v--
(Address) Ck-.:- . t'... to.
(Phone) qS'L - 'f'-f(j - (,,j 2-6
(Phone) ~r J - ~;l- 3- 4-1'-0 I
(Phone) ~/L- qQO -S2-$."Yj{c)
~ISe-YVl.Oh.J'l.+ ft.I,,1 _s'5.7J6 Jy
TYPE OF WORK D New Construction ODeck OPorch e-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection 0 Misc.
I hereby certify that I have filrnished mformation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authoflzed agent for the
above-mentIOned 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 for Just cause Fl11thermore, I hereby agree that the City official or a designee may enter upon the property to perform needed mspecl1ons.
. 11/4/ - 41 '-If 6/ :vJ tJ_~
Contractor's License No.
CODE: '&JI.R.C. DI.B.c.
Type of <(<instruction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
x
Permit Valuation
Permit Fee $ 7'1, 7 S-
Plan Check Fee $ -
State Surcharge $ 7, z.s
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
~~~
.. .. .
Bulldlllo Olllclnl
~Jcs
I tJ. ()",it). 00
,
B
S U
PROJECT COST IV ALUE $
(excluding land)
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 $ -........ 0
f r?/~ 6
,
I Paid -it" ,00
Date Il/oS
I Receipt NO-:'91 ~fI'
By jj.
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 constttutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Cerl1ficate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447.4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
~/
/7/J~ U/oodvte0 Cr-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
DATE nue
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
o PLUMBING FINAL
d MeCH RNAL /J
1 e/091
COMMENTS:
ZJ5:. J'G 0
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
WORK SATISFACTORY, PROCEED
CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FO EINSPECTION BEFORE COVERING
Inspector:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!