HomeMy WebLinkAboutBldg Permit 05-0172
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
3. 1. or'
White File
Pink City
Yellow Applicant
PERMIT NO. t15: ()f7Z-
(Please type or print and si~ at bottom)
ADDRESS
Z~1o
,F191iW /CW
eo
.rw
ZONING (office use)
IGlJ'O
LEGAL DESCRIPTION (office use only)
LOT.:J BLOCK
ADDITION
FHI HA/I r;::L-J .r ~
PID ~r: I~ 2..001_ U
OWNER
(N ame)
(Phone)
(Address)
BUILDER
(Company Name) Jt.~ b
(Contact Name) J I~
,:}f'PU
U-A- UJ/.J.,f
(Phone) ~'5 J - '-fJ,~ -q~J J"
(Phone)
WJi.J I '" ,/::).'-(
I
(Address)
12.., t.I .;'
ot:lk C--O~~1rl1c..,.iDJJ
.f lQ t..c D #oJ f-
f7i'htvo~/) r.,.....fJl .
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TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing -~e-Siding OLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection 0 Misc.
CODE: DI.R.C. DI.B.C.
Type of Constnlction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST IV ALUE $
(excluding land)
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-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
OffiClart=c revoke thIS permit for Just cause FUt1hermore, I hereby agree that the CIty offiCial or a deSIgnee may enter upon the property to perform needed mspectlOns
X Q. ~ ~-1-6)
~ Signature Contractor's License No Date
I Permit Valuation Park Support Fee # $
I Permit Fee $ SAC # $
I Plan Check Fee $ Water Meter Size 5/8"; 1"; $
I State Surcharge $ Pressure Reducer $
I Penalty $ Sewer/Water Connection Fee # $
I Plumbing Permit Fee $ Water Tower Fee # $
I Mechanical Permit Fee $ Builder's Deposit $
I Sewer & Water Permit Fee $ Other $
I Gas Fireplace Permit Fee $ TOTAL DUE $ 7 (p. 00
This Application Becomes Your Building Permit When Approved
Paid
Date
7c,. fI ()
3. '7. OJ-
ReceijfJ:'
By If..l
flY;>r
Building Otlicial
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 temporaty Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Cerl1ficate of Occupancy must be
issued
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
J.f1Q 0
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
SCHEDULED
r:UVVKIr./ Yl cI
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~4H~
COMMENTS:
----
/' / /01"'"-
( V!/L
~'
--
OA TE TIME
'l-).,/~
S--/7L
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
-,.,~
r'~ ')
~
----------
~ WORK SATISFACTORY, PROCEED
/0 CORRECT ACTION AND PROCEED
o CORRECT '1lryf# FOR REINSPECTION BEFORE COVERING
Inspector: J1J Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI