HomeMy WebLinkAboutBuilding Permit 04-0599
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(p .rl. 04-
; ~i~':: ~:~ I PERMIT NO. OA.. CJ 59Q I
). Yellow Applicant -r-;
(Please tvDe or orint and sign at bottom)
ADDRESS ZONING (office use)
tJ 5 I () J A-L1 J( :;0 r7 f~ !fJt, f) ~
,
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
~W::e~R r<o~ OS-rf)/?t:
(Address) -j/;J--
~~~;~;R ( ~-L If
(Contact Name) i!-W../f
(Address) if/o 0 e-'It CL-5 ('0 JI' AIl/rL sf! 0 {/IL;
TYPE OF WORK
o Misc.
(Phone)
PID25. 087. 011. 0
q 52J-P1C Ot;J,<;3
(Phone) _'0'2 3 ~ CJc{ c;
(Phone) ;;Zoz <9 7~_7<;
PaJ'Ie-
ODeck OPorch ORe-Roofing ~Re-Siding
o Fireplace DAddition DAlteration DUtility Connection
PROJECT COST IV ALUE (excluding land) $ /2 31 J _
o New Construction
DLower Level Finish
I hereby certify that I have furnished information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or
authorized agent for the above-mentioned y.....y...nj and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;terupo prope~;:/;1ctions C -17- L-/
/ Signature Contractor's License No. Date \
1 Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Pennit Fee
\ Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Pennit Fee
$
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
This Application Becomes Your Building Permit When Approved
I Paid
I Date
/'v.C/?/
&./7.17 ~
Building Official
Date
# $
# $
$
$
# $
# $
$
$
$ '7ro - ~@
Receipu1?o. 4-7.:l- us-
By ,{
(J
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. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director Date Special Conditions. if any
24 hour notiee for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS $.L()
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATJQ.N~
INAL ~,
~ITE INSPECTIO
COMMENTS:
DATE nME
SCHEDULED 8:.l e-01
~~- (~
CONTR.
PERMIT NO. _1./- 5rJ
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
I. OeJr::. lo~~ '^~ ~
SFACTORY, PROCEED
CTION AND PROCEED
RK, CALL FOR REINSPECTION BEFORE COVERING
Inspe
Owner/Contr:
FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
'NSNOn