HomeMy WebLinkAboutBldg Permit 05-0855
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and siltIl at bottom)
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT \ \n BLOCK ~ ADDITION ~"L\'.;"'<:o..
OWNER
(N ame)
(Address)
BUILDER
(Company Name) W '-~ '"'--,____
(Contact Name) \..') L4_
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Date Rec' d
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White
Pink
Yellow
I PERMIT NO. ()5.fJes91
File
City
Applicant
ZONING (office usc)
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PID25.37S-. tJ(Pb. 0
(Phone)
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(Phone) ~\~ ~o' ",\0,
(Address) \. ~~
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TYPE OF WORK 0 New Construction ODeck o Porch ORe-Roofing ORe-Siding
OAddition o Alteration OUtility Connection
CODE: OI.R.C. OI.B.C. ~- ~ I~ ~ / ~"-"'...... ~"'''~E- Misc. ~~ """~ - \;;.---
Type ofConstroction: I II III IV V A B \Q~~ROJECT COST/VALVE
Occupancy Group: A B E F HIM R S V ( I d" I d)
Division: 1 2 3 4 5 exc u mg an
~Lower Level Finish 0 Fireplace
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I hcreby certify that I have hlrnished mformation on this application which is to the best of my knowledge true and COlTec!. I also certify that I am the owner or authonzed agent for the
above-mentlllned property 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 buildmg
official can revoke this permit for Just cause Furthermore, I hereby agree that the City official or a designee may enter upon the propelTy to perform needed mspectIons.
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Signature
Permit Valuation I tJ OtJ. -'
Permit Fee $ a'f,,/)L
Plan Check Fee $
State Surcharge $ ,b"'O
Penalty $
Plumbing Permit Fee $ q'tJ .-
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Building Otlicial
Date
\.""-&~
Contractor's License No.
~ \/0 ~
Date
Park Support Fee
SAC
# $
# $
I $
I $
# $
# $
$
$
t1. 2 ,OS- $
75 z5
I
Y'7"~ J
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE t!attuC
Paid
Date
-7 S. ?~
4 If: pS--
/-
Receipt N qJ.
By j
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ThiS IS to certify that the request in the above applicallon 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 Zonmg compliance and allows construction to commence. Bcfore occupancy, a Certificate of Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Special Conditions, if any
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS ..371#5 ~. 'E:I8S ~T.
NATURE OF WORK ~6J6 . 5" I.-
USE OF BUILDING ~ -
PERMIT NO. ".5: ATE ISSUED V. OS-
CONTRACTOR ~ 'AI PHONE~/.~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
,
INSPECTOR
DATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
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COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
EL:t:CTRICAL
PLlJ.MBING
HEATING
DO NOT
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.
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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
DATE TIME
CITY OF PRIOR LAKE 'J I':J" L
INSPECTION NOTICE SCHEDULED I ()/~
ADDRESS ,11) (gC:; - \ \ p ~ 'C 'K.. ~ .
OWNER
CONTR.
PHONE NO.
PERMIT NO.
)-8~
o FOOTING
o FOUNDATION
o FRAMING
~ ~SULA T10N
2 ~~NAL
o SITE INSPECTION
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 GAS LINE AIR TST
o
COMMENTS:
L. L. ~''^(~
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRE W . CALL FOR REINSPECTION BEFORE COVERING
Inspe r:
Owner/Contr:
OR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
1REMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
I/iSNOTI