HomeMy WebLinkAboutBldg 06-0012 VOID/REVOKED
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(P. 3 0.00
I White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 0(, .. 001 ~
(Please type or print and sign at bottom)
ADDRESS
33/3 0rZ1cqGj~
ST.
ZONING (office use)
,e IS LJ
LEGAL DESCRIPTION (office use only)
LOT 3 BLOCK 5 ADDITION
PID 25. 4-32... () z.z.. ()
OWNER
(Name)
(Address)
i BUILDER
(Company Name)
I (Contact Name)
(Address) /9005
(!,.oA/C6pr Bu t/J:)e"es
7-0/VI WOre.. 7H (...,~y
2/7N& s7 _ /I/. JAI. ( &' LJ<::. ,e /V61f!!.-
(Phone)
(Phone)
65330
fL,12.. Z-Z I, 396(P
C,/2.. 2'10. ell7
TYPE OF WORK kiNew Construction ODeck OPorch ORe-Roofing
~Addition OAlteration OUtility ConnectIon
ORe-Siding
~p~ Finish prt'irePlace
CODE: ~I.R.C. OLB.C. o Misc.
Type of onstnlction: I II III IV V A B
Occupancy Group: A B E F H I M R S U
Division: I 2 3 4 5
PROJECTCOST/VALUE $ 32~, 000
(excluding land)
I hercby c('rtit)' that I have tUfOlshed mformation nn this application which IS to the best of my knowledge true and correct. I also certify that I am the owner Of <luthonzcd agent for the
abnve-menlloned property and that all Cllnstructlon will contlJrm to eXIstmg state and local laws and will proceed in accordance with submitted plans. I am aware that the blllldmg
~t1Clal can rcvllke t ~ rml/42~"thel~ ~ that the elty Officia;~deSl~~;a~;~p; ;: property to perform n;~~ /3H):~ b
Signature ) / Contractor's License No_ Date
II f
!fI S l.S-, D ~, , O'f)
I
$ 2."103, so
$ Is tD '2., z..B
$ IlPz.$"O
$
$
$
$
$
Permit Valuation
Park Support Fee
#
$
Gas Fireplace PermIt Fee
/OO,Q.()
IOD,fJO
3S.S'0
4a,oo
Water Tower Fee
#
$15S'c,o~
$ 32-S' .00
$ /0 o. ()()
$ /.6'iIJ, 0-0
$ I CJ (J 6, eo
$i~(7(!), oLJ
Permit Fee
SAC
#
State Surcharge
Water Meter Size 5/8"(0
Pressure Reducer
Plan Check Fee
Penalty
Sewer/Water Connection Fee
#
Plumbing Permit Fee
Mechal11cal Permit Fee
Builder's Deposit
Sewer & Water Permit Fee
Other
TOTAL DUE
~~
l~lIildll1i! Ulrlclal
J/-11letJ V
I Paid I Ot ~ -Lt>.,i:>
I Date '-1' ~ ~
Receipt No. S\C{cO
By (4) Jk-
This Application Becomes Y OUlr Building Permit When Approved
I'I1IS IS to certify that the request 10 the above application and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested TillS document
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Planfling Director Special Conditions, if any
24 hour notice for all inspections (952) 447-9850. fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
tl~l, TIME
(~\~SSI.g.~.
'CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
~~\-S
OWNER
CONTR.
PHONE NO.
PERMIT NO.
10 FOOTING
10 FOUNDATION
10 FRAMING
o INSULATION
~INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
D(p - 12..
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS: I p~ l t" l-s 12e-vo~
~~O~ ~~N\.~ ~r~
~ ~(~~ -,/~oloe_
~, Nn I..t~~ ~ ~~
O,.J 11+c S pAA.r.ht _
:s ~,..,l Au.- t-."f~ :p~1) tNO{~
.
'-~ ~-M.6N F\c..JE- ~ "5~~~;
St-+t{ t ('t:>M,J~ r ~ i- ~ ~-..61. tE:C
t+- ~ ~C:,J "f'Ai 1:> - .
.tt.. ~,u-~tr~ ~ f,vLJ')d2S ~Vr
7.-
,::) ,
L-Lc::>e; 1S- H u:;.-
'~WORK SATISFACTO V, PROCE.D
o CORRECT A TION NO PROCEED
o CORRECT LL FOR'itt:mSPECTION BEFORE COVERING
Inspector: ,~ ~ner/Contr:
CALL 447-9850 FOR TH~ Nt:xTI'NSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!