HomeMy WebLinkAboutBldg Permit 05-0795
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
J': II. oS
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City
Applicant
I PERMITNO'OG: 07951
(Please type or print and sign at bottom)
ADDRESS
49gB
nlfl//l/6S0m
ZONING (office use)
$1.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID Z5~003. 0(2...0
OWNER
(Name)
!ZU 55 k"b1Gk-O tAl
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
.~.
TYPE OF WORK 0 New Construction 1siDeck OPorch ORe-Roofing
OAddition OAlteratj6rl OUtility Connection
CODE: IYfR.C. DI.B.c. 0 Misc.
Type of ~stnlction: I II ill IV V A B
Occupancy Group: A B E F HIM R S U
Division: 1 2 3 4 5
ORe-Siding OLower Level Finish
o Fireplace
PROJECT COST IV ALUE $
(excluding land)
I hereby certifY that I have furnished 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-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
~ this ermit or J st cause Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed mVe~;:'7. o..s--
Contractor's License No. Date
I Permit Valuation Park Support Fee # $
I Permit Fee $ 73.75 SAC # $
I Plan Check Fee $ 4-1. 14- Water Meter Size5/8"; 1"; $
I State Surcharge $ 1.00 Pressure Reducer $
I Penalty $ Sewer/Water Connection Fee # $
I Plumbing Permit Fee $ Water Tower Fee # $
I Mechanical Permit Fee $ I Builder's Deposit $
I Sewer & Water Permit Fee $ I Other $
I Gas Fireplace Permit Fee $ I TOTAL DUE $ 1~Z,..-1P9
/l ,
- 4fJ'7tP
This Application Becomes Your Building Pennit When Approved Paid 12-z. (p l ~.
~~ xhf5 Date - f:?- CY By
Building Otlicial
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 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
"
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS #~8 n/!J/tvbJ(}11I s:r:
TYPE OF WORK tJtU-
USE OF BUILDING /tGS q/~
PERMIT NO. or . () 795' DATE ISSUED i~/7~ ~ J--
BUILDER h~vJ PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR D"TE /
I FOOTING I ~ I ~7Pt-
PLACE NO CONCRETE UNTIL ABOVE H~ BEEN SIGNED
FRAMING I //W / I
FINAL
A
VW/
1/"lq~
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECnON NOTICE
SCHEDULED
ADDRESS
qq~ ~U~ >r
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION /l. ~
~L f /'Uo({
o SITE INSPECTION
COMMENTS:
(
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0')
I l ~
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CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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DATE TIME
7-/~rd(,
C;7Cf.S
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOjfK~ FOR REINSPECTION BEFORE COVERING
Inspector: !/ 1/ r Owner/Contr.
I
~tl_ "7-9850 FO~ nus NE~T IN~pF.CnON 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
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