HomeMy WebLinkAboutBuilding Permit 04-0466
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I ~;;;:fs;' orin' ~d.~ ~~~)t?
Date Rec' d
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PERMIT NO. 04 .04/tJ/t? I
File
City
Applicant
,~~~u O~
ZONING (office use)
lC; fJ
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
(Phone)
1">1, 2Z'-
z.s,"7
OWNER ...L
(Name) ere. T
15 0 .,.I-t..
(Address)
i<--
PID
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ~eck OPorch ORe-Roofing
OAddition o Alteration OUtility ConnectIOn 0 Misc.
CODE: ~.R.C. OI.B.C.
Type of.t;;stmction: I II III IV V A B
Occupancy Group: A B E F HIM R S U
Division: I 2 3 4 5
ORe-Siding OLower Level Finish
o Fireplace
PROJECT COST IV ALUE $
(excluding land)
I hereby certily that I have hlrmshed mformation on this application which is to the best of my knowledge true and correct. I also certily that I am the owner or authonzed agent for the
above-mentIOned property and that all construction will conform to all eXist 109 state and local laws and will proceed in accordance with submlttcd plans. I am aware that the buildmg
<llftcial can rev<lke this permit for Just cause Fu. ermore, I hereby agree that the City olftcial or a designee may enter upon the propelty to perform needed mspectl<lns.
~~ ~_I+,O~
X 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 $
This Application Becomes Your Building Pennit When Approved
~~~
8uildllH! Om'cial
5/17~ y
, Date
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 tA1Mro .r. t &.04- $ 95's
ThiS IS to certily that the request 10 the above applicatIOn and accompany 109 documents is 10 accordance with the City Zoning Ordinance and may proceed as requested ThIS document
when signed by the City Planner llIstltutes a temporary Certificate of Zonmg compliance and allows construction to commence Before occupancy, a Certificate of Occupancy must be
lssue
s,ll.N_
Date
Special Conditions, if any
4 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Thl' Ct'nlt'r of lht' I.akt Counlr)'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
,
L,....
APPLICATION RECEIVED
1--
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Iii
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i i . t
f+\ L
Accepted
\{
Accepted With Corrections
Date:
~ III .0+
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid.",
__'_~~"_"_'_~~"'__~~___-'-"'~'_"'~_""_~'__"__~__"" "-_'_ _"__. . _.,_.,_ __~_.._.._._~m_.._.___.____
White
Pink
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Thl' Ct'nlt'r (If the I.akr ('ounlr)
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
B 0 I2-n+J B~
6.[4.04--
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
lJillO
L-ftJt.,G .r lOb ME;.
/'
Accepted With Corrections
Accepted
Denied
~ ~ Date: 5/t?~<(
, f
~ ~-~,
Reviewed By:
Comments:
~
........
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
I-NSPECTION
RECORD
SITE ADDRESS / ~ II () LAUSIOc AVE,
TYPE OF WORK )/EW l)EC!Jt-
USE OF BUILDING $'::; () ·
PERMIT NO. 04 04-b~ DATE ISSUED 5117!~"
BUILDER '&tLEf &,aTH PHONE#'S2-21t,-ZS??
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING \.0 4- trI c;- 2- 5
PLACE NO CONCRETE UNTIL ABOVE H~S BEEN SIGNED
_II
[FINAL I M( I
L1...~<J
FOR~ALL INSPECTIONS (952) 447-9850
..