HomeMy WebLinkAboutBldg Permit 05-0321
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I ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
c;l. '2) (d~
White File
Pink City
Yellow Applicant
PERMIT NO. 05 0.32 I
Scf/3 /1J~76(.t7.VUZJn
[J /(.
ZONING (office use)
PUD
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
PID 25. '2 /.~ O(,Jq 0
OWNER
(N ame)
::r4k"
S'l7J
(Address)
Ij ./?/I" f! ~C r
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(Phone)~~tY03- ?6?6
BUILDER (l.
(Company Name) O€.N (ltJ()~"J" +- ~f)f1aINC-
(Contact Nam~/d l.Z- ,.;(i:J4.(),1J
(Address) ~ ~ .E..L- ~L.,.J
(phone) #~_(':.?74/_7
(Phone)
S'I .
/'4/"~N~
- '"
1
TYPE OF WORK 0 New Construction ODeck o Porch M'ke.Roofing ORe.Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtiIity Conn~~ 0 Misc.
CODE: OI.R.C. OI.B.C.
Type of ConstIuction:
Occupancy Gronp: A B
Division:
I
E
PROJECT COST IV ALUE $
(excluding land)
II
F
1
III IV V A
HIM R
2 3 4 5
B
S U
I hereby certifY that I have Furnished Information 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. 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 building
official can 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 Inspections.
~~ ZO].C;/J~b t!-,Z5-tJJ
/ ' Signature Contractor's License No. . Date
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
Z, 50 () (J (]
$
$
$
$
$
$
$
$
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$ ''7&.00
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
'7&. (/'J
/' -'! ."--
't' . Zj ,C!.
Receipt ~,-~--):'~ <1 u. ~
By /V't/J~ ..
,/-
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 conSl1tutcs 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 S<i, 1 :s
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
!;,~~SU~N ~
~NAL eot'"
D. SITE INS ECTION
COMMENTS:
SCHEDULED
~~
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
tJ" ~~ ~ S~
n, 1"
r' .~O~-
J
- I
/Yt-L ');r V?
,hr;/
5'&~
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~ /
rORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRJfJORK' CALL FOR REINSPECTlON BEFORE COVERING
Inspector:. ( Owner/Contr:
CA ~ FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl