HomeMy WebLinkAboutBldg Permit 05-1224
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ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White
2 Pink
] Yellow
File
City
Applicant
PERMIT NO. 05. rz..:2...+-
I? ,91Jt!
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ZONING (office use)
kr
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION ,Sec+
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PIq-.)5~ qo~. () /3"" 0
OWNER ~ 12 l/l/\ I,
(Name) ........On')!J b,2..IUl:.AL-
(Address) \LP~\tv.l\l{ ~ S~
BUILDER
(Company Name)
(Contact Name)
, (Address)
(Phone)
iiSd-tHl-4<{:L
(Phone)
(Phone)
ORe-Siding OLower Level Finish 0 FirePlaceg rC< d e
;;4r~S5 W;,pdouJ - levcl I \
'---J U/ I IV J () ,;v
PROJECT COST /V ALUE $
(excluding land) IV D we 1/
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition o Alteration OUtility Connection
CODE: DI.R.C. DI.B.C. o Misc.
Type of Construction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: 1 2 3 4 5
I hereby certify that I have fiJrnished 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 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 ca revoke this permit for Just cause Furthermore, I hereby agree that the City official or a designee may enter upon the property to perform needed mspections.
X .'. L. . ~DS-
Signature Contractor's License No. Date
\ Permit Valuation
I Permit Fee
\ Plan Check Fee
\ State Surcharge
Penalty
Plumbing Permit Fee
\ Mechanical Permit Fee
\ Sewer & Water Permit Fee
\ Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
~ C:;OD.--
'1 Lj-7t:;
I-d&)
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$ 11rJ. 00
Water Meter Size 5/8"; I";
Pressure Reducer
tt
#
#
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
'1(,.{) 0
Il..-P 0 . ().S
Receipi No. .51JPJ37-
BYr^
Buildinf;! Official
Date
ThiS IS to certify that the request in the above applicallon 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 Zonmg compliance and allows construction to commence. Before occupancy, a Cerllflcate of Occupancy must be
issued
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
Planning Director
CITY OF PRIOR LAKE
INSPECTION NOTICE
;;~ TIME
/
~d"H 1/
/'
SCHEDULED
ADDRESS /U /7
OWNER
CONTR.
PHONE NO.
PERMIT NO. S -/'.2-2 y/'
o PLUMBING RI 0 EXIGRADIFILLlNG
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
~L 0 PLUMBING FINAL 0 GASLlNE AIR TST
o SITE INSPECTION . .0 MECH FINAL. /0
COMMENTS: ~reSJ' c:::.G/';'~
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~ ~~RRECT ACTION AND PROCEED
o CORRECT~O , CALL F R REINSPECT_ION BEFORE COVERING
. ----
Inspector: Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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