HomeMy WebLinkAboutBldg Permit 05-0280
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER ~
(Name~ / ,WI 111 'rHY
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(Address)
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(~pa~Name)
(Contact Name)
(Address)
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Date Rec' d
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White
Pink
Yellow
File
City
Applicant
PERMIT NO. 0.5.0280
ZONING (office use)
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LAKE
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(Phone)
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(Phone)
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TYPE OF WORK 0 New Construction DDeck o Porch ~oofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection 0 Misc.
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CODE: DI.R.C. DI.B.c. PROJECT COST IV ALUE S /,.~O~
Type of Constroction: I II III IV V A B (excluding land)
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5
I hereby certify t I have furnished mformation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authOrIzed agent for the
above-mentlo property and that all c struction will conform to all existin al laws and will proceed in accordance with submitted plans. I am aware that the buildmg
:cial c~r Just r a designee may enter upon the property to perform ne~c;); po oS--
,7 Contractor's License No. I Date
Permit Valuation .~> C;VU. 00
C-,
Permit 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 Permit When Approved
Building Ollicial
Date
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
10.00
Water Meter Sizes/8";l";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
#
#
Paid
Date
1'v',UO
q-j 1 - () 5'
Receipt No. <f t) It! <j
By v11f{t:t.-
ThIS IS to certify that the request in the above application and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner constltutes 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
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,
CONTR.
OWNER
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
~ MECH FINAL /J
/Ce ,va 0 T-'
COMMENTS:
MDATE TIME
- ..-'
0.....\
~
6lS- ;..2?o
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, C~;Y;>WSPECTION BEFORE COVERING
Inspector: /' ~ L" ">wner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSIiOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI