HomeMy WebLinkAboutBldg Permit 04-0743
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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2. Pink City
3 Yellow Applicant
PERMIT NO. 04---. 07431
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ADDRESS
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ZONING (office use)
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LEGAL DESCRtr uON (office use only)
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LOT ISBLOCK ADDITION L S oj L J 0 ANt.J.A <:..,..~ i<As A()bl'lfID "Z S; 0 , "Z. 0 I'~O
(Address)
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(Phone) (~ <; 2.... )4...{ 7 - ~ ISO
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OWNER
(Name)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK. 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
o Addition OAlteration OUtility Connection 0 Misc. ~~ fare /;i"fl 51/ AJtj Oe..LlC-
CODE: DI.R.C. DI.B.C. PRoilcT COST/VALUE $
Type of Construction: I IT ill IV V A B (excluding land)
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
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 necded Inspections.
X
Signature Contractor's License No. Date
I Permit Valuation 4ooB.- I Park Support Fee # $
I Permit Fee $ 103 CJO I SAC # $
Plan Check Fee $ (p(p q.s I Water Meter Size 5/8"; I"; $
State Surcharge $ 1-- ()O I Pressure Reducer $
I Penalty $ I Sewer/Water Connection Fee # $
I Plumbing Permit Fee $ I Water Tower Fee # $
I Mechanical Permit Fee $ I Builder's Deposit $
Sewer & Water Permit Fee $ I Other $
Gas Fireplace Permit Fee $ I TOTAL DUE $ 17/ q.r
es Your Building Pennit When Approved Paid (If: 1 ~~ Recei]?t No. c.f' 111 ~ J
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Date ?-;J-I-Of4 By C
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Date I
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 constitutes 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
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PRIOR LAKE
INSPECTION
SITE ADDRESS Erq~~
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TYPE OF WORK
USE OF BUILDING
PERMIT NO. 04.074-3 DATE ISSUED 7-)..1-0"/
BUILDER Q~~ PHONE # 1fE::J. ~'S"D
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
~~,
FOOTING I 1#1:1 I ~/J6Ti~L/'
~LACE NO CONCRETE UNTIL ABOVE HAS BEEN SIG'NED
I f'RAMING ~1 I I
I
FINAL
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Call between 8:00 and 9:00 A.M: for ~II inspections / . "
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS ~~~ ~~
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
~I ULATION
IHAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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COMMENTS:
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DATE nilE
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o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
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~ORK SA
/0 'coRRECT ACTION AND PRO ED
o CORRECT WO REINSPECTION BEFORE COVERING
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Inspector:
Owner/Contr:
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CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
IN$NOTl
CODE REQUIREMENTS A.RE FOR YOUR PERSONAL HEALTH & SAFETYI
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