HomeMy WebLinkAboutBldg Permit 04-0535
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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File
City
Applicant
I PERMITNO'Vt/-~3~
(Please type or print and sign at bottom)
ADDRESS /S3 l- I G-J. I ~ r
tV' I () V t'<!L~.
./
LEGAL DESCRIPTION (office use only)
LOT3 BLOCK b ADDITION / J ) fJ/rr-<J/714.t:1!/'JZ~ L<:. +-
\/ --~
Fa ;,1:- u ".y
/U1/ .~~"372
ZONING (office use)
1<)
PID;;?L;-- 3 J} t, ~() 79 -0
OWNER
(Name)
13 \I'ClcR f'l?A/
-.J
Kd.Jc
(Phone)
'152 - '--/C/7-190 7
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
I
(Phone) /
/
TYPE OF WORK 0 New Construction d@eck o Porch ORe-Roofing ORe-Siding
OAddition OAlteratfoY OUtiJity Connection 0 Misc.
o Fireplace
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
B
S U
PROJECT ST/VALUE $
ding land}
I hereby certity thaI I have nlrnlshed mformation on lhis application which IS to the best of my knowkdgc true and correct. I also certIfy that I am the owner or authonzed agent for the
above. mentioned plOpel ty and that all construction WIll conform to all eXlstmg slate and local laws and wIll plOceed m accordance With submlttcd plans I am awarc that the blllldmg
~fiClal can ~~~~y~1 ~~t the Clty offiCIal or a designee may enter upon the ploperty to perform 2 pft y
- ~arure ":?_-:::-, o~l- Contractor's License No __ ( $/ba(te /~I'
Permit ValuatIOn ,,~v" Park Support Fee #
Permit Fee $ 73, 75 I SAC # $ I
Plan Check Fee $ 47.lJL( I Water Meter Size 5/8"; 1"; $ I I
State Surcharge $ J . (J 0 I Pressure Reducer $ I I
Penalty $ I Sewer/Water Connection Fee # $ I
Plumbing Permit Fee $ I Water Tower Fee # $ I
Mechanical Permit Fee $ I Builder's Deposit $ i. I
$ I Other $ ~ I
$ I TOTAL DUE $ Jzz, bCJ I
Ufo ~L.f'~/
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
2f::.:'oo;:;;m,p;'i:~P;"d
Buildll1g Oflicial 'Da\e '
Paid
Date
J ,7d- .d'J I
I /;.., ~ '3 - Lj<
Receipt No.
By ~
d-
ThIS IS to certi/)' that the request III the above applical10n and accompanying documents is in accordance with the City Zoning Ordinance and may procecd as rcqllestcd. ThiS document
when signed by the City Planner constItutes a temporary Ccrtificate of Zonmg compliance and allows construclion to commence. Before occupancy, a Certlticatc of Occupancy mllsl be
isslIcd
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
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,'.. :
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS 15 3 2 ( l4) i &.OS PA.flJL 1A1""
TYPE OF WORK ~e.c,...) beev--
USE OF BUILDING /JJl" 515 S.F: \). <
PERMIT NO. ~ DATE ISSUED ~/..{oc.(
BUILDER "'lSeA.Dc..E"V lCU.aJ~ PHONE #~ - q\( '7 - LRo 7
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
, FOOTING I /I\~ I (" ~ ). "(.-OVI
PLACE NO CONCRETE UNTIL ABOVE J1AS BEEN SIGNED
-->> FRAMING l;rs IS l / - 2D
<.: P,iCfC.. ,. b€C.t'- ~ PLA~~ I j
J FINAL I III Ir'Z/ ff0
( /
FOR ALL INSPECTIONS (952) 447-9850
. . .
..
~
~
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS -'5~Q\ IJ.JA< ~~
OWNER CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
P5. FINAL ~
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
c~ \- C~~ (~?l.
DATE TIME
9,nJoeo
q -t;~(
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
o WORK SATISFACTORY, PROCEED
~ORRECT ACTION AND PROCEED
o COR~~LL FOR REINSPECTION BEFORE COVERING
Inspect fr: ()! / Owner/Contr:
C P.L~50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
'-"
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!