HomeMy WebLinkAboutBuilding 06-0832
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
9 I Z. () 6
(Please
ADDRESS
/4-/1.5
LJ /tV VP'<-
White
Pink
Ye1\ow
File
City
Applicant
\ PERMIT NO.
o & ~ OB3z..\
ZONING (office use)
UI<-
IG1
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
(Phone) ~ ~~.. Lf'i S"- ~3 '1 ~
OWNER I/....L. n \, o1Uf
(Name)~~\- \~ ~
PID -ZS'~ 404-. d sf 0
(Address)
r \ BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe. Roofing ORe.Siding, rtlLower Level Finish 0 Fireplace
OAddition o Alteration OUtility ConnectlOn ~
CODE: OI.R.C. OI.B.C. o Misc
Type of Construction: I II III IV V A B PROJECT COST /V ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: 1 2 3 4 5
I hereby certify that I have furnished mformation on this application which IS to the best of my knowledge true and COlTect. I also certify that I am the owner or authorized agent for the
above-mentioned property and that all construction will conform to all eXlstmg state and local laws and will proceed m accordance with submitted plans I am aware that the buildmg
official can evo ,t IS per t r Just cause Furthermore, I hereby agree that the City official or a designee may enter upon the prope11y to perform needed mspectlons
; ~~
x
Signature
Permit Valuation 5 fJ 0.. , ·
Permit Fee $ 30/, 7tf-r '
--~"----- -
Plan Check Fee $
State Surcharge $ . !7J
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee I $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Date
Contractor's License No.
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOT AL DUE $ 35. 2-5"'"
\ Paid 3 s: z-r
. Date ~/Z, 0 "
I rtNOJZV"l'l
\' '
J
Buildlllg Official
J
ThIS IS to certify that the request m the above application and accompanYll1g 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 Zonmg compliance and allows construction to commence. Befme occupancy, a Certlflcate 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
-
SITE ADDRESS /~/9.5 P/1-0c;a::-- (!4~
TYPE OF WORK L - t.- .
USE OF BUILDING ~ ;za ~/J2-
PERMIT NO. 6'. 0 fJ Z- DATE ISSUED 1. /2-. 0 ~
BUILDER /tI eq ~ PHONE #
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
~ I
PLACE NO CONCRETE UNTIL A 0
FRAMING
INSPECTOR
DATE
I FINAL
1
FOR ALL INSPECTIONS (952) 447-9850