HomeMy WebLinkAboutBuilding Permit 01-0778
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CITY OF PRIOR LAKE BUILDING PERMI l,
. TEMPORARY CERTIFICAlE OF ZONING COMPLIANLE
AND UTILITY CONNECTION PERMIt
(please type or print and sign at bottom)
ADDRESS
15zs-9 PR/~RN'K.S
LOT (p BLOCK
LEGAL DESCRIPTION (office use only)
1. White File
2, Pink City
3 , Yellow Applicant
Date Rec' d
7 - z, f-,C) /
PERMIl'NO.01_071%
ZONING (office use)
JeIW
ADDITION ~/:JP~ I'~c.. .JJId/l-g
PID Z~ -().3 fI ... 6 0 (p -i)
OWNER
(Name)
(Address)
BUILDER I I ...-!'"'t
(Name) C n r.'J~,'a"r A,.JC
(Contact Name) -.eJ-lc.J c.K
(Address) ILfio P~r ~ 2J.
TYPE OF WORK
o Misc.
(Phone)
(Phone) 91"2 -~ 7/J- "'0 () I
(phone)
ChA,J~'" S J-t',v
o New Construction
OLower Level Finish
o Deck
..
)(Re-ROOfing
OAlteration
PROJECf COST IV ALUE (excluding land) S
o Fireplace
o Porch
OAddition
ORe-Siding
OUtility Connection
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 confvuu to all existing state and local laws 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
;teruponthefr1Z:'l,;:.;:=ons '::171'1.-- 71.J.tf /01
r'fffj7'Signature Contractor's License No. Date
P~uuit Valuation
Permit Fee
I Plan Check Fee
State Surcharge
Penalty
Plumbing Pc.uuit Fee
Mechanical Pc.~1Uit Fee
Sewer & Water P~uu.it Fee
Gas Fireplace P~uuit Fee
$
$
$
$
$
$
$
$
z, ~ () (). (S u
74-.7S
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This Application Becomes Your Building Permit When AI'I'&'" lied
11.J% l' tA', () I
Building Official
Date
Park Support Fee
SAC
#
#
$
$
S
$
$
$
S
$
$ 711- trf)
ReceJ/}Jo~ I (, ,'I
By r--
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
issued.
Planning Director
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
#
#
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Paid
Date
'7v.() 0
7. VI' ..', I
CITY OF PRIOR LAKE
INSPECTfON NOTICE
.
SCHEDULED
ADDRESS
1S-2..S'f
Pt4c- ~<
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL~. U ~L G FINAL
[] SITE INSPECTI [] MECH FI
COMMEN: r<. - rOdF- 1tJ-(J
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DATE nilE
l-JLJ
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J- j7~
o EXIGRADIFtLllNG
o COMPLAINT
O. FIREPLACE RI
a FIREPLACE FINAL
[J GASUNE AIR TST
a
I~'\ 4-
r:;-- -
! ( Ce
_ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
[] CORRE.CT."f~ :;rq,;r.Ec::nON BEFORE COVERING
Inspector: r /1/ ' ;? Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
I1I!IItOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
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