HomeMy WebLinkAboutBldg Permit 05-0193
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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City
Applicant
(Please type or print and sign at bottom)
ADDRESS
/5~./
r y eJvt (J~ It 1/ c:.....
LEGAL DESCRIPTION (office use only)
Date Rec' d
I PERMIT NO.Or~_
/1 "3
ZONING (office use)
f)SD
LOT t). BLOCK I
ADDITION ~teAt.d
r
V~ L(tJ- PID:;l?J - cQLf9 -- 005 -()
OWNER
(Name) 7IitSOrJ
,otJ S6V
,
~ .,IIv'e
(Phone) "1Vl-7~ - ~"A
(Phone)
(Phone)
?.n~J
(Address)
Iml
BUILDER '17
(Company Name) D1CIIf)r ~#b-
(Contact Name) g'f<ll..p ~~/l/
(Address) /2:St 0 CR.tJwJJ Ihu (!::'"1
gt.l(2.JJflJluG
V/2-&>.sJ-?> 55
i ~
TYPE OF WORK 0 New Construction ODeck o Porch fiRe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connee'tk.m D Misc.
CODE: DI.R.C. DI.B.C.
Type of Constroction:
Occupancy Group: A B
Division:
B
S U
PROJECT COST /V ALUE $
(excluding land)
I
E
II
F
1
III IV V A
HIM R
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 authOrIzed agent for the
above-mentlOned property and that all c ruction will conform to all existing state and local laws and will proceed in accordance with submitted plans. I am aware that the building
:ficial can ~ st se Fmlhermore, I hereby agree that the City official "2:;/;g1 2;9n the property to perform needed;~~I;n:eP ~
, / Signature Contractor's License No. Date
Permit Valuation ;:} 5-00.-
Permit Fee $ 7l(--7S-
Plan Check Fee $
State Surcharge $ //a-~
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace 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
TOTAL DUE
This Application Becomes Your Building Permit When Approved
7" ./
~ ~ al-u~
Paid
Date
Building Otlicial
Date
# $
# $
$
$
# $
# $
$
$
$ 7~.
Receipt No. UY071
By cr f
,p.
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 constitutes 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
ADDRESS / S8 2./
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o jliISULA nON
"rr FINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED ~jL-15~
~~_'i-.~
CONTR.
PERMIT NO.
5-175
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o (O~ H,- (}~
~ ,....... lb-
_ J,.- ....~
I \' ULJ/
/
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT LL FOR REINSPECTION BEFORE COVERING
Inspector: I Owner/Contr:
CA Lk-9850~OeJHE NEXT INSPECTION 24 HOURS IN ADVANCE.
Cl)~ l\1!.~ENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOTI