HomeMy WebLinkAboutBuilding Permit 05-0305
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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LEGAL DESCRIPTION (office use only)
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BLOCK
ADDITION
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File
City
Applicant
PERMIT NO.~5 - 305
ZONING (office use)
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BUILDER ... .-' ..,.. ..----.
(Company NamB}- ~r;- -c::::.-. '<":~~ L---
(Contact Name)
(Address)
(Phone)
(Phone)
o Fireplace
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish
/ OAddition OAlteration OUtility Connection 0 Misc. 5 ~~ 8 l< l ?....
CODE: 01.R.c. DI.B.C. L) PROJECT COST/VALUE $
Type of Construction: I II III IV (!) A (JYs." A (excluding land)
Occupancy Group: A B E F HIM R <)!/
Division: I 2 3 4 5
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I hereby certify that I have hlrnished mformation on this application which is to the best of my knowledge true and correct. I also cerlli)' that I am the owner or authOrized agent for the
above-menlloned property and that all construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
"fficial can revoke thIS permit for Just cause Furthermore, I hereby agree that the CIty official or a designee may enter upon the property to perlorm needed mspectlons
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Signature
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit
Contractor's License No
4 -'"'t-\ -C>~-
Date
Park Support Fee
SAC
_/
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid
Date
Receipt No,
By
ThIS IS to certii)' that the request in the above applicatIOn and accompanying doeuments is in accordance with the City loning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner constItutes a temporaty Certificate of loning compliance and allows construction to commence. Before occupancy, 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 DEPARTMENT OF
. BUILDING AND INSPECTION
INSPECTION
RECORD
SITE ADDRESS ( &? 1 /3 t:dl-~~ L/t-A/b
TYPE OF WORK /2.Gs ,;1-/~
USE OF BUILDING A= /3ur<-t2lA-t..
PERMIT NO. bJ,S1 - 366 DATE 155 ED
BUILDER JSf2-JAIV PA2-t::6fL- PHONE # 4--~. s27C:.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I FOOTING I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I I
I FINAL I I
FOR ALL INSPECTIONS (952) 447-9850
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