HomeMy WebLinkAboutBldg Permit 05-0742
(Please tvoe or unnt and sign at bottom)
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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White
Pink
Yellow
File
City
Applicant
, PERMIT NO. 0 5. u7~zj
/7/'77
/0/7 M~
ZONING (office use)
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
OWNER
(Name)
(Address)
ADDITION
PID
(Phone)
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(Phone)
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~-Siding DLower Level Finish 0 Fireplace
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TYPE OF WORK 0 New Construction DDeck DPorch ~-Roofing
DAddition DAlteration o Utility Conn~-
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
o Misc.
I
E
II
F
I
III
H
2
IV V
I M
3 4
A
R
5
B
S U
PROJECT COST IV ALUE
(excluding land)
$ /~ ~ ,-
I hereby certify that I have htrnished mformation on this applicatllln which is III the best of my knowledge true and correct. I also certIfY that I am the owner or authOrIzed agent for the
above-mentlllned property and that all construction will conform III all exisl1ng state and local laws and will proceed in accordance with submllted plans. I am aware that the buildmg
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S&'t:e Contractor's License No
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
I $
I $
I $
Park Support Fee
SAC
# $
# $
$
$
# $
# $
$
$
$ '1&JJ 0
Receipt No. .y-ct}' rrG
By tI--
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
Buildlllg Official
Paid
Date
?fL.VO
V'.I,O r
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. TillS document
when signed by the CJty Planner conStItutes a temporary Certificate of Zonmg 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
SCHEDULED
DATE TIME
/~.zA,t
, I
ADDRESS
/7/77 J04 CJ-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
s- 7~~
o FOOTING 0 PLUMBING RI 0 EXIGRADIFILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
~tNAL 0 PLUMBING FINAL 0 GASLINE AIR TST
o SITE INSPECTION 0 MECH FI?J-.. /'JD" -
COMMENTS: Aroo r r--~S"cd(?_
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C/(C
~K SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~~'; ;.?FOR REINSPECTION BEFORE COVERING
Inspector: /~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY/
INSNOTl