HomeMy WebLinkAboutBldg Permit 05-1134
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
If. (0, dr
I White
2. Pink
3 Yellow
File
City
Applicant
I PERMIT NO. fJS"'.
1/34-1
(Please type or print and sign at bottom)
ADDRESS
fjrrrJ/c- ~ 0 ~
eo,
Yo 2.'2-
LEGAL DESCRIPTION (office use only) ~
LOT .I BLOCK .I ADDITION -Y/7i;/J; ikd rp aJu B -r ex
ZONING (office use)
PID z;.r. 57/. (JO I. 0
OWNER
(N ame)
(Phone)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
Co rL c..J- .
(Phone)~S)4 'S '7 - 7 0 ~ .3
(Phone)
2C-~'Lt
Bb ~ eft. & c-rk
\ -
TYPE OF WORK 0 New Construction ODeck DPorch ORe-Roofing ~-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Connection
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
o Misc.
III IV V
HIM
234
B
S U
II
F
1
A
R
5
I
E
PROJECT COST IV ALUE $
(excluding land)
I hereby certifY that I have ["rnished mformation 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 local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
:"fiCial can revoke t~~m~_2r Just c~;:: I hereby agree that the City official or a designee may enter upon the property to perform necdi ;~p;;:. 0 r
Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
Sewer & Water Permit Fee
Gas Fireplace PermIt Fee
TOTAL DUE
This Application Becomes Your Building Permit When Approved
p(p,f.)..J
.I1.1f). fir
Paid
Date
Buildl11!! Otlicial
Date
$
$
$
$
$
$
$
$
$
7&.00
No. Sl;J77
I
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 Zonmg compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
isstled
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
OWNER
CONTR.
DATE TIME
//~ds-
, ,
R?df e
S--- /-<?~
.RIOR LAKE
_~TlON NOTICE
SCHEDULED
ADDRESS
JO;2.2
A~)
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
"""'-0 SITE INSPECTION
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
- t' ~ F, ,
Y" (fi:;;:t? I /.." ~ 4
\( I/'!9
,f' ~
.--7 ?
,/"~'S~~ t
a /?L?e w} /"
//
r-
..",--? / / .
(. a' GI/ ~ ~/? ('
C/ /L.-
~.~)
/' ~s~;-:, W
~R~TISF~
o CORRECT ACTION AND PROCEED
o CORRECT WOR':;A~..? REINSPECTION BEFORE COVERING
Inspector: .... ~/ "'* Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
~
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl