HomeMy WebLinkAboutBldg Permit 05-0629
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ADDRESS
ISQ.9
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. 05. oh z..,7
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT ~LOCK 3DDITION
OWNER
(N ame)
1)011/'
I S(.2?
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
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~
PID 0 II
CJ/9
6c>41/5-"\ c../(
YY7" <(08)-
(Phone)
4/1 ( I) Wv..J I)
elL
(Phone)
(Phone)
TYPE OF WORK 0 New Construction DDeck DPorc~ -==>.~;:Ofing ~ DLower Level Finish 0 Fireplace
DAddition o Alteration DUtility Connection
CODE: OI.R.C. OI.B.C.
Type of Constmction:
Occupancy Group: A B
Division:
o Misc.
I
E
II
F
1
III IV
H I
2 3
V
M
4
A
R
5
B
S U
PROJECT COST IV ALUE $
(excluding land)
. ..-".,..-... ---
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 authonzed agent for the
above-mentlOned propel5and 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 can revoke thIS per or J,~ F rthermor I hereby agree that the CIty offiCIal or a deSignee may enter upon the property to perform needed mspectlOns.
X /~ P~. .7,..-/rOC
Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$
I
I
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
'7b.OO
This Application Becomes Your Building Permit When Approved
Paid
Date
i'/!J. W
111. Or
I
Receipt 1YQ, ~9,Z- S
ByA~
1
Building Ofticial
Date
Thts IS to certify that the request in the above applicauon and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. Thts document
when signed by the City Planner constItutes a temporary Certificate of Zoning compliance and allows construcuon 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
DATE TIME
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/S0~Cj
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FI~AL/
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. -
COMMENTS:
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r / 7..,~ 45 /-ft?"d'.
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o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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.
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~"WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~~Jff FORREINSPECTION BEFORE COVERING
Inspector: J!VJ~ Owner/Contr:
. /'
CALL 447-9850 FOR, THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!