HomeMy WebLinkAboutBldg Permit 04-1203
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sip at bottom)
~\(OO~~ ~~ ~~(
~'(\O(
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name) ~;?A-
~r~
(Address) 1?.L) _ ~ ~~"'1 "2-
BUILDER
(Company Name) k'(\.~~'?
(Contact Name) t:>a..~~Qj
(Address) A:'~l ~O'^~ So.
Date Rec' d
), White File I PERMIT NO
2. Pink City . tJ).A - r- """'3
3 Yellow Applicant I ~
\Q..~
ZONING (office use)
f2- .. 2-
Mr-J
S> ;'1 '2..
PID 2.5'-t:f~ -lX)"t-O
(Phone) '1)L-~- 431/
IIIfc..s ft/.,v 5"""'S" ~~
+: \ e.. o.~ '-'<.or e..
~eV\.\L\O
~~~
(Phone) ~('- Z2.\ ~17i?
(Phone)
JL11V ~S'~7q
,un...t
TYPE OF WORK ~~ew Construction ODeck o Porch ORe-Roofing ORe-Siding DLower Level Finish 0 Fireplace
~dditlOn DAlteration DUtility Connection 0 Misc. s=,c/C!12-..ter!- /f~~c..S
CODE: DI.R.C.~.B.C. ~~ PROJECT COST/VALUE $
Type ofConstructiol'""C I II ill IV V (excluding land)
Occupancy Group: A B E FVJ IRS U
Division: 1 2 3 4 5
,
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
ion will conform to all existing state and loca/laws and will proceed in accordance with submitted plans. I am aware that the building
to,. ~ .. ")' I hereby agree that the city official or a designee may enter upon the property to perform needed IOspections.
t' 12...~.Ctl
- Contractor's License No.
x
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
I Gas Fireplace Permit Fee
"'Z'-.CJO.-
$ 74,7C;-
$ ,
$ (.. z-'; -
$
$
$
$
$
our Buil!.ing Permit wr /proved
IZ- /~k>+
, Dite
Date
I Park Support Fee # $
I SAC # $
I Water Meter SizeS/8"; 1"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
I Other $
I TOTAL DUE $ ~.. -
I Paid 1~~Ok Receipt No. ~
I Date By f
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 Celtificate of Occupancy must be
issued.
Planning Director
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
DATE nilE
~S-
/60~ S;!
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS 0/6~ ""~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~L
o SITE INSPECTION
o PLUMBING RI
o MECH RJ
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
~. 4LOJ
o EXIGRADlFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
c/ 1./ /
//1'/Id~q'/-5 .~ CJft ~o
eN ch ~S-A:;;o/'J,'
'~ - /
/
tC7/(
A WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORJ~./UIN.!SPECTION BEFORE COVERING
,_ p,VC/ ~o-'lComr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI