HomeMy WebLinkAboutBuilding Permit 04-0288
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
1If./1. 04-
; ~i~;; ~:~ I PERMIT NO. 0 .I! . 0" i2 a, I
3. Yellow Applicant ~ vc/ l/
(Please ~ or mint and sign. at bottom)
ADDRESS
/S S' ~o !/,-d/c.. C. ,'r__le... tV. W. . U; Dr L....kCe-
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name) _Tennv ~/v i J/o
(Address) /S.1.. 8 S ~ r "0" 0'J p,.,'o r L,,-4C~ . M-J
(Phone)
BUILDER
(Name) 1Yit:t..A"'AJ'" Ii Bu ;/,.../.. r'"
(Contact Name) &rn i.- '
..-,-
:.L J1.-.
(Phone) <JS..2_ WJ-.;1.. ?,f,f
(Phone) to I~ - 3'-9 - 3, ....tl
(Address)
7J'77 fA) ISo S-J-. S"tUa.~~. /Yl~
c
TYPE OF WORK
~Re.Rooling
o New Construction
ODeck
o Fireplace
OPorch
OAddition
DAlteration
DLower Level Finish
o Misc.
PROJECT COST IV ALUE (excluding land) $
ZONING (office use)
PID -ZS'. 'lOCI. 00 I. 0
95.2.- *..,- (,7//
~Re.Siding
Dutility Connection
..10."oV _
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
enter upon the property to perform needed inspections.
X 0~, /71_dn- . IQ
Signature
d-,.3..s+
Contractor's License No.
I Permit Valuation 2,!>oo.oO I Park Support Fee
I Permit Fee $ "7~. '75 I SAC
I Plan Check Fee $ ~ I Water Meter Size 5/8"; 1 ";
I State Surcharge $ /.25 I Pressure Reducer
I Penalty $ I Sewer/Water Connection Fee
I Plumbing Permit Fee $ I Water Tower Fee
I Mechanical Permit Fee $ I Builder's Deposit
I Sewer & Water Permit Fee $ I Other
I Gas Fireplace Permit Fee $ I TOTAL DUE
This Application Becomes Your Building Permit When Approved
'lr, .VlJ
,.. U~4-
Paid
Date
Building Official
Date
f-//s/o~
Date
# $
# $
$
$
# $
# $
$
$
$ ~(p 00
/\ I
I ~~: H/6>V
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
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS I C;p,';2.C) A..t'r (\ ~..-
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 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: UZrt ~~
rll tJ W Ac<JL-~ \
'/
DATE TIME
r~-/l y")~
t../ - Zp.~
\.....-
o EXIGRAOfFlLLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
./
/}
( II /)
I P
)(,WORK SATISFACT ?RY I~D
o CORRECT ACTION ~ PROCEED
o CORRE(ZRK. CALL FOR REINSPECTlON BEFORE COVERING
Inspector: J.~ Owner/Contr:
CAt! 7&850 FJ THE NEXT INSPECTION 24 HOURSiN-AnYANCE.
CODE REQ"uIRkNTS ARE FOR YOUR PERSONAL HEALTH & SAFE
7---- INSNOTJ