HomeMy WebLinkAboutBuilding Permit 04-0336
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
O~
1--1- I-
I PERMIT NO. 04- .Q33("
). White
2. Pink
J, Yellow
File
City
Applicant
(Please type or print and sign at bottom)
ADDRESS i4-1 Z I M\.f5f~~ L-f\~
N E- COe.N E-SZ... OF c.T'I &3. E; W I <-l::l..S
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
\-oJ E:rJ Srv"\ tDt..v N He....... E:..s.
(Address)
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BUILDER
(Name.
(Contact Name)
(Address)
Ft.A.2..A
[)~I V'S
p~
ZONING (office use)
AI
PID?:>. QU/3 /) 03. I
(Phone) 012. ~I OlIO
.D R.... 's"""7E- 2.=
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. SAdl E:..
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A<:" ABDV~
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TYPE OF WORK
o New Construction
DLower Level Finish
(Phone)
(Phone"
IVI ,.J
&5/:>""2.......
o Fireplace
DAlteration
DRe-Roofing- ~'", ORe-Siding
DUtility Connection
DDeck
DPorch
DAddition
ylMiSC. TE/Y'If> SALE-50 OFHLE.. PROJECTCOST/VALUE (exc1udingland) $
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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 property and that all construction will conform to all existing state and loca11aws 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
;ter ~perform needed insP:ctiOns 1'-133 &JILPEe-#" '-1/1 /0'-1
.... .......: \ Signature Contractor's License No. ' Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
! Gas Fireplace Permit Fee
~.:?tJtJ(). ()~
$ ~ZS
$ 57. 3~
$ !. ~(j
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
~~.:if~
- Building Official'
f/Z(a/ai
Date
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1 It;
I Pressure Reducer
I City SAC and WAC
I Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE
Paid
Date
/';-7. II
S.IO. ()-
#
#
#
#
$
$
$
$
$
$
$
$
$ /'17. fI
i
I ReceiprU 0, ~6 'f/f
I By -1.-
o
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
~isSU'd. ,_
" .
~ Piannj~g
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4, J-(p 6\f
\ _ Date 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
..
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION
RECORD
WILOS PItTH
TRAJL~
t!- S>+ur -
DATE ISSUED $1&11..1/
,
: BUILDER . PHONE #
" NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
SITE ADDRESS
TYPE OF WORK
USE OF BUILDING
. PERMIT NO. -1J4,033'(O
INSPECTOR
DATE
I FOOTlNG~.&" I I
,
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I I
I FINAL
/} J I
'f -15 I ;//0; tJ tS
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
Ilf12(
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
P-"!INAL
o SITE INSPECTION
COMMENTS:
SCHEDULED
t'\~ .,4,"c.
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
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nMe
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I
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/'
~RK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CO~\ 1ffK. CALL FOR RElNSPECTION BEFORE COVERING
Inope or: II/ Owner/Contr:
C L U~850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
'v.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
I/'iSNOTl