HomeMy WebLinkAboutBldg Permit 05-1184
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/2. Z.OS
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City
Applicant
PERMIT NO. 05. / 184-
(Please type or print and si~ at bottom)
ADDRESS
/(P/58 &/l/cGJYOb /1~6::If/C/b
LEGAL DESCRIPTION (office use only)
ZONING (office use)
LOT
BLOCK
ADDITION
PID Z5. o9ro.ozz./
(Phone) 9S-2. if L/7. 03 t5D
(Phone)
MN.
OWNER
(Name)
(Phone)
(Address)
BUILDER
(Company Name)~ fuf\&'UNiU.\
(Contact Name) ~ "'-\ -:y ~~ tJ
(Address) \ f1\.f'1u ~h..(-DWnJ 'KD.
--
,J::.N c. .
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TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection
CODE: DI.R.C. DI.B.c. ~iSC ee;p/111L
Type of Construction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hercby certify that I have fl1rnished mformation on this application which is to the best of my knowledge true and correct. I also certify that I am the owncr or authonzed agent for thc
above-m~,'~~~Jt:h;~~;:ll constructlOn wtll conform to all eXistmg state and local laws and wtll proceed m accOldance with submitted plans I am aware that the blllldmg
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Signature Contractor's Ltcense No Date
Permit Valuation
Permit Fee $ 74. 7 S-
Plan Check Fee $ -
State Surcharge $ (.~~
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
$
$
$
$
$
$
$
$
$ 7h.~
This Application Becomes Your Building Permit When Approved
Paid
Date
7(,.f./V
/2_2_0$
I~SZ;BO$
I By ~
Building Ollicial
Date
Thts is to certifY that the request in the above applicatlOn and accompanying documents is in accordance with the City Zoning Ordinancc and may proceed as requested. This document
when signed by the City Planner constitutes a tcmporary Certificate of Zonmg compliancc and allows construction to commence. Before occupancy, a Certlficatc 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
. . --r-' .,
~
~
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS /&/:58 t:--/iIC-6S /'06
TYPE OF WORK r=,~p~ hu-5~~(.L
USE OF BUILDING Res A/,:z
PERMIT NO.5. 118 +- DATE ISSUED /2. Z.oS-
BUILDER tSX ~f5/e.T /tl/lJu/'J /2A-/ PHONE # 4+7 ()300
/
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
~"'.1."""""-U- T"l-\(2-a::> -. ~ I I J
PLACE NO CONCRETE UNTil ABOVE HAS BEEN SIGNED
liJ'-1.riG;';~\q t=LUG- I I I
ANAL I
FOR ALL INSPECTIONS (952) 447-9850
_.~" ~~ .'-r-'.'~
DATE TIME
CITY OF PRIOR LAKE -L~'(x-
INSPECTION NOTICE SCHEDULED
ADDRESS I ~/~15 ~t,,~'~
OWNER CONTR.
PHONE NO. PERMIT NO. ..Y II ~Cj
o FOOTING o PLUMBING RI o EXIGRADIFILLlNG
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATIONr tv o SEWER HOOKUP o FIREPLACE FINAL
~INAL . o PLUMBING FINAL o GASLlNE AIR TST
o SITE INSPECTION o MECH FINAL 0
COMMENTS:
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT Won;/'JR REINSPECTION BEFORE COVERING
Inspector: -Y If Owner/Contr:
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOT/
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