HomeMy WebLinkAboutBuilding Permit 01-0266
I !
CITY OF PRIOR LAKE BUILDING PERMIT, . : (II
TEMPORARY CERTIFICATE OF ZONING COMPLIANcE;! !
AND UTILITY CONNECTION PERMIT
. .:Ifrmc'd
. 'l_"
I. White File
2. Pink City
J. Yellow Applicant
I PERMIT NO. 01 ~ 01i(P(,
I Z1t7G(Offi"usel I
(Please !VD~ or Drint and sUm at bottom)
ADDRESS
/ '/-(. ~ y CA-J((2.. IA tK~ LA-A/,,~
LEGAL DESCRIPTION (office use only)
LOT /''7 BLOCK '2.---' ADDITION C If~ I;/~IC Hlt.(...5 'L;..t I?
PID Q5-.).9t- elf.;L-()
OWNER
(Name) Bit A 0 .J- !3/~e 1<7 P rt.= / rlr: I(
(Phone) OJ./z - V9-d - 6W-)L.
(Address) /y.r;I/5!- C""'/lft/~d'~ J..AMI.i .rJt/d;<( .<.AXI'" M","
BUILDER
(NameYn".i Did ,Jt:: N-I#?
(Address) //6:3 '- If'-'~d^, At/I'i n
f-.r J 7' 2--
(Phone) (I Z. - ~"v- z'v /..r
INV$/t. (;.o,vft IIp/~h'7./ /\41# ~77
W,,1't. r... IN <-
j3 New Construction
OLower Level Finish
TYPE OF WORK
o Misc.
8:>eck
o Fireplace
OPorch
ORe-Roofmg
ORe-Siding
OAddition OAlteration OUtility Connection
/ .,.,
PROJECT COST IV ALUE (excluding land) $ "3/.)() c7 K'i'
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 upo~''''1''...:~rform. needed inspections.
X --A7,/d/W... .&' "--~Y7 ~-V-OI
v ,~~ Sigqt{ure I, 3C!JO. ClIO Contractor's License No. Date
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
)"'./)
ecome
Planning Director
$
$
$
$
$
$
$
$
t.P? 'll':>
~/.\~
. c.. t)
I Park Support Fee
I SAC
I Water Meter
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
#
#
$
$
$
$
$
$
$
$
Size 5/8"; 1 ";
#
#
$ '79. ~ f!;
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
..
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 11/(.44 (lM""~ I d-- q
TYPE OF WORK ti);/"{ c
USE OF BUILDING SF/)
PERMIT NO. ()l - o-V00 DATE ISSUED 4- c,- - 2tJo(
BUILDER 'i:),c(C" ~ ~ r
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
T~E PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
, FOOTING I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
~" I I
, FINAL
Call between 8:00 and 9:00 A.M. for all Inspections
FOR ALL INSPECTIONS 447-9850
I.!..,
.'\
. . . ..
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
7/zzb- ItT(
ADDRESS
I 'f (p '-II.{
(I . ~
-~-
CONTR.
OWNER
PHONE NO.
PERMIT NO.
(5 (-Oz..k s;.
o FOOTING
o FOUNDATION @J
o FRAMING
o INSULATION
"isl:lFINAL
6 SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINA
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
;ti WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ . Owner/Contr:
CALL "7-9860 FOR THE NEXT INSPECTION 2A HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNDTI