HomeMy WebLinkAboutBldg Permit 05-0659
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and si~n at bottom)
ADDRESS
Date Rec' d
I. White
2 Pink
3 Yellow
File
City
Applicant
1 PERMIT NO. 05 - ft;J6'1
33~1
~~fJ,
LEGAL DESCRIPTION (office use only)
LOr! t!BLOCK 3 ADDITION
OWNER
(Name)
/ Lld~ cb-t;Jt?
--ro IJ1 VV(:! (5/'
') '3}. / Ujilc1 ffcYSe
(Address)
(Address)
j/j' r lj.;'5trr
J'vl,Ju
'1 U ')0
BUILDER
(Company Name)
(Contact Name)
/A./
h>J6n C;)
J
,1l00tA Y-
(Phone)
pvdl"
-r11 ( ~
(Phone)
(Phone)
,MvdCfI1
ZONING (office use)
PI0375 -C)d--~
'-I'I() -3 (70
Cf1 J1-j ?--I~
<:))1 <) ..J
TYPE OF WORK 0 New Construction DDeck DPorch ~-Roofing ORe-Siding DLower Level Finish 0 Fireplace
DAddition DAlteration DUtility Connection
CODE: DI.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V
HIM
234
o Misc.
A
R
5
B
S U
PROJECT COST IV ALUE $
(excluding land)
-1~/O. OJ
I hereby certifY that I have hlrnished mformation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or authonzed agent for the
above-mentioned properry and that all construction will conform to all existmg state and local laws and will proceed in accordance with submitted plans. I am aware that the buildmg
official can r.e~ this permit for Just cause FU?~'~ore, I hereby agree that the Clly official or a designee may enter upon the property to perform needed mspectlons.
X ~tdri!l~~ _Y YU4'- ,~O/ alii )--- / II I I () \-
Signature '-- Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
dOt'Y)/---
7L/- 7~
!'dS-
This Application Becomes Your Building Permit When Approved
Buildl1l!l Onicial
Date
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
l TOTAL DUE
"7/ .-
Paid la _
Date f -11- ':>
$
$
$
$
$
$
$
$
$ 7ft:,/
I Rec~tNo. i!O!Ji i
IBY~
#
#
#
#
~
ThIS IS to certify that the request in the above applical10n and accompanying documents is m accordance with the City Zoning Ordinance and may proceed as requested. TIllS 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
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS :J.;3, Li
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
SCHEDULED ~f~~
wM~~
TIME
CONTR.
PERMIT NO.
5 - (p!;)C,
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADIFILUNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
O..,QASlINE "A\ TST
o ~). ~~l"">.
~WORKSATISFACTORY, PROCEED
o CORREC~TION AND PROCEED
o CORREC r ORK, CAll FOR REINSPECTION BEFORE COVERING
Inspector: /1 Owner/Contr:
CALLJ47-~ FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
/'
CODE1l.EQUlREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSNOrl