HomeMy WebLinkAboutBldg Permit 05-0266
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and si2l1 at bottom)
ADDRESS
5" b q 5" G t!P1tt. WTJ7JJ)
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LEGAL DESCRIPTION (office use only)
LOT/3 BLOCK 3 ADDITION,S;:p./O
Date Rec' d
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Pink
Yellow
File
City
Applicant
PERMIT NO. 05"".0 2 fIl~
ZONING (office use)
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PID 2..5.2-11- _ 034-,0
OWNER
(Name)
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Cf?DM- 1.1 ~J !I. N ~ ~
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
q52-2~/-3qz?,
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-R~ng ORe-Siding OLower Level Finish 0 Fireplace
OAddition DAlteration DUtility Connection ~ Misc. ~u:l:r.f t../I"/O" ".J .I'If pt;:'n.- /frf7VOt't/t
CODE: DI.R.c. DI.B,c. PROJECTCOST/VALUE $ 5'~~
Type of Construction: I II III IV V A B (excluding land)
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
I hereby certifY that 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 authonzed agent for the
above-mentlOned properry 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 building
official can revoke this permit for Just cause Furthermore, I hereby agree that the Clry official or a designee may enter upon the property to perform needed mspectl()tls.
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Signature
Permit Valuation
Permit Fee
Z ~" (). ()()
2500
/'i; .Z5
I !:>-O
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
$
$
$
$
$
$
$
$
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
:&;;:n ~~BnilWng P7k/;;'"
Building Ollicinl I Dhte
Contractor's License No.
Date
Park Support Fee
SAC
$
$
$
$
$
$
$
$
$
,H75
#
#
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
#
#
Builder's Deposit
Other
TOTAL DUE
Paid
Date
1f'/~ 75
~. f3~C1s
Receipt No. -'l.t#34:1'
By ~
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 conSl1tutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Cerl1ficate 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
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SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o:s~ - ...26~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
..Ja"'f'INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
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~ORKSAT~ORy.PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~O' ;,~OR REINSPECTION BEFORE COVERING
Inspector: y~ Owner/Contr:
/
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI