HomeMy WebLinkAboutBuilding Permit 04-1236
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/2 J ]. ~ y
White File
Pink City
Yellow Applicant
PERMIT NO.1)'! -i ~ '5,k
(Please
ADDRESS
ZONING (office use)
Lr(5'~b
d!LJ/c;Ndo ~-;-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID ZJ. '00 I./l-J. 0
OWNER
(Name)). ANI fL.
"..-'r
'^"'~ ( H Jr.. A
(Phone)
b/:J -<79; ),'<1 I)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Constr~ion ODeck OPorch ORe-Roofing
OAddition )/lJAlteration OUtility Connection ~ Misc.
CODE: ~I.R.C. OI.B.C.
Type of t;;'nstruction: I II III 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 0 Fireplace
f,~...,. ~14~ ~~
PROJECT COST /V ALUE $ ! 7b,:2 7
(excluding land)
I hereby certity that I have turn 'hed lOf 'mation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner Dr authorIzed agent for the
Jbove-mentlOned property an that all onstruction wlll conform to all eXlstlOg state and local laws and will proceed in accordance with submitted plans. I am aware that the build 109
:Iicial can revok' s p 1 or Just use FlllthermOle, I hereby agree that the City offiCial or a deSignee may enter upon the plOperty to perform needed jS3tH~ns1 _ O~
Contractor's LIcense No Date
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee O~
Mechanical Permit Fee
&, tJ tJ
Park Support Fee # $
SAC # $
,
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ /9&,/'1
Permit Valuation
Permit Fee
~BIT~"Bdm' P'~;;;;~"d
BuildltH! Ofticial Date
Paid
Date
;;;~.;
/2./ t
I~;~. nfp#&
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 ZonlOg compliance and allllws construction to commence. Before llccupaney, a CertIficate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
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
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING
PERMIT NO.
CONTRACTOR a. Ha.e ~ PHON I
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
~i1
. . . .
.. -
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
UILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
FOR ALL INSPECTIONS (952) 447-9850