HomeMy WebLinkAboutBuilding Permit 05-1098
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
n at bottom)
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Date Rec' d
II. I. OS
I White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 05. / Or a I
ZONING (office use)
F
/22-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID Z5. +00. 0(,0.0
OWNER
(Name)
<:ZJ Fo}(
(Phone)
Y 52 /..f '17 (;'! 3c;
8i-'UC e
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding
OAddition OAlteration o Utility ConnectIOn
ower Level Finish 0 Fireplace
CODE: OI.R.C. OI.B.C. o Misc.
Type of Construction: I II III IV V A B JECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I 2 3 4 5
I hereby certify that I have hlrmshed mt()rmatlOn on this applicatIOn which IS to the best of my knowledge true and COlTect. I also certIFY that I am the owner or authonzed agent I(l! the
above-mentIOned property and that all Cllnstrllction will conform to all existmg state and local laws and will proceed in accordance with submItted plans I am aware that the buddmg
"mclal ca,n r~ke thIS pel mIl fm Just calise FUI thel more, I hel eby agree that the CIty offiCial or a desIgnee may enter upon the plOp cIty to pel form needed mspectlons
x~~O /~ ~d 1.1 of)
Signature Contractor's License No Date
Permit Valuation 2, 0 () 0 . 6 0
Permit Fee $ (, 'l . ZS"
Plan Check Fee $ -
State Surcharge $ /.O()
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fec $
This Application Becomes Your Building Permit When Approved
8uilulll~ Ofticlal
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fec # $
Water Tower Fee # $
Builder's Deposit $
Other a~M-''- $
TOTAL DUE $
ThiS IS to certify that the request m the above applicatIon and accompanYing documents IS m accordance with the City Zoning Ordmance and may proceed as requested TIllS document
when signed by the City Planner constItutes a temporalY Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certlticate 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 /7<F1 0 .o~b LO O/L .
NATURE OF WORK L-()W610 L8V6L--
USE OF BUILDING J2E;..f rl/rG-
PERMIT NO. 05. /()qfJ DATE ISSUED 1/1,,0s-'
CONTRACTOR ~X PHONE 44-7,0/30
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
~ I I
I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
~------
-
FRAMING
INSULATION
ELECTRICAL
r- ,., )
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I .,
FINALS
BUILDING
ELECTRICAL
-1-- 1/~
HEATING I 0" ~ J ~
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