HomeMy WebLinkAboutBuilding Permit 05-0467
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
5.2-4-. os
l'fj~81
I White
Pink
J Yellow
File
City
Applicant
I PERMIT NO. (J5: () ~61
(Please
ADDRESS
ZONING (office use)
If., 0/3
/Vo~Vd?)LJ ,eL).
~/JO
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID Z5. ,1-/. 083
I
OWNER
(Name)
f11, k. e. ---';,'" /, ~, I-r
(Phone)
"S"0l - ;;J.~.JI) . '17 ~ T
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction
OAddition OAlter io
CODE: ~I.R.C. DI.B.C.
Type of J:nstntction: I II
Occupancy Group: A B E F
Division: I
Deck OPorch ORe-Roofing
OUtility Connection
ORe-Siding OLower Level Finish
o Fireplace
o Misc.
III
H
2
IV
I
3
V
M
4
A
R
5
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby eerllfy that I have hlrmshed mformation on this applicatlOn which is to the best of my knowledge true and cOlTeet. I also certifY that I am the owner or authorized agent I,)r the
abnve-mentlllned property and that all construction will conform to all exrstmg state and local laws and will proceed in accordance with submItted plans. I am aware that the buildmg
,,!fIClal can revoke thIs permIt for Just cause FlIlthermore, I hereby agree that the City offiCIal or a deSignee may enter upon the plOperty to perform needed mspecllons
_~~ ~ --- .s=Zr- oS-
~ -- C ~ - Slgnatu Contractor's Ltcense No Date
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
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 t 1ntet:J to - ( .-O.r- $ /47."
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
~P~Ii'"tiOO B~om~:;og p",,", Whrn ;pp,,,,,
~c~ 61(fas
Paid
Date
/t1;~?~
i ~;"iPtN"t/ ;0
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 TillS document
when signed by the City Planner eonstltutes a temporaty Certificate of Zoning compliance and allows constructlOn to commence. Before occupancy, a Certltlcate of Occupancy must be
I 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
SITE ADDRESS I ~O /3 A/(}~O?:JO ,eL).
TYPE OF WORK Ot&:-
USE OF BUILDING ;u;I /-1-1/L
PERMIT NO. OJ- ()4&7 DATE ISSUED 5. z.f: 0 s-
BUILDER 7lh~ PHONE# Zz&.4-1Js-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
6)(ISTIM FtJonA./.
FOOTING /JUq ON n~~:r~~ .
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
.... I I
lJ{1 ~
INSPECTOR
DATE
I FINAL
/ /
9//-1 /67
/ /
FOR ALL INSPECTIONS (952) 447-9850