HomeMy WebLinkAboutBuilding Permit 04-0367
CITY OF PRIOR LAKE BUILDING PERMIl,
TEMPORARY {;ERTIFICAIE OF ZONING COMPLIANCE
a\ND UTILITY CONNECTION PERMIT
Date Rec' d
S, :J. ()~
l'
(please type or print and sip at bottom)
ADDRESS
1-09 /
UJt-O~OO
LEGAL DESCRIPTION (office use only)
I. White File
2. Pink City
3 . Yellow Applicant
SI .
s.c.
LOTn BLOCK 2- ADDITION LAK,GSID6 tql4,e..oeAlS
OWNER
(Name)
(Address)
PERMIT NO. Of. 0.1'7
ZONING (ofticeuse)
R../SL)
PID 2.':; -~- CJ2j- a
{JENIS6 Mt,g~/06
SAH6
(Phone) q 5";1 -~ J (, - ~ 1Cf \p
BillLDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o New Construction
OLower Level Finish
(Phone)
(Phone)
o Deck
o Porch
~RDOfing
OAlteration
PROJECT COST IV ALUE (excluding land) S
o Fireplace
OAddition
o Misc.
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 conform 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
;.~~~~~.neededinspecti~~ inN 3'P- to"'''
J SignF~- Contractor's License No. Date
.
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing P.:.uuit Fee
Mechanical P':'~Ulit Fee
Sewer & Water P.:.uuit Fee
2, 500. 00
$' 74.?S-
$
$
$
$
$
$
$
/.zG'
Gas Fireplace P.:.uuit Fee
This Application Becomes Your Building Permit When Al'l'& w led
~
Building Official
Date
Park Support Fee
SAC
Water Meter
Size 5/8"; 1";
#
#
#
#
$
$
$
$
$
$
$
$
n 7(,. 0 0
f
~~f7
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 te...I'~.ary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid
Date
7f?.tI () _
S-. "] *,' .-.-
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIllE
ADDRESS
SCHEDULED. ~t.~oy
?teA ( {jj frR~
OWNER
CONTR.
PHONE NO.
L{ -:<'C?
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
(] SITE INSPECTION
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
(] SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
V-c - ~
o EXlGRADIFILUNG
o COMPLAINT
o FIREPLACE RI
(] FIREPLACE FINAL
(] GASLlNE AIR TST
o
~
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/ / I, _
( / lOST'
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~WORK SATISFACTORY. PROCEED
[J CORRECT ACTION AND PROCEED
(] CORRECT WO~. ~R REINSPECTION BEFORE COVERING
Inspector: V /I r Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOn
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