HomeMy WebLinkAboutBuilding Permit 01-0268
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
4-' (p-O I
(Please .!VD~ or print and sie;n at bottom)
ADDRESS
14-42-5 BIIA.t.bwp.. Inti'
LEGAL DESCRIPTION (ollice use only)
I. White File
2. Pink City
3. Yellow Applicant
ZONING (office use)
N&
LOT Z BLOCK Z. ADDITION /<.NOg HILL 4-1H
PIDZS-~2-017-0
OWNER
(Name)
(Address)
Pf.-VI"V I P+\7_IO
I + 4- 2-'7 -e, IIAf --b I Y A. IVXlI I
(Phone)
Q52.-Z:B-z"'J61
NFo
BUILDER ~1V C&n, -h.A.1.:h/M
(Name) (Phone) q~L- 44t> - II C. 7)
(Address) I ;1l\P II v?'Y1 tA'tl--Wa.4-ev-- D\r I ~ a..\a{f~'" HI-5 ~~"8
TYPE OF WORK ~ew Construction ~eck OPorch ORe,Roofmg ORe-Siding
OLower Level Finish o Fireplace OAddition OAlteration OUtility Connection
o Misc.
PROJECTCOST/VALUE (excluding land) $ (p I !leO . 00
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 th~ to perform needed inspections.
X r~L l..D2-lvllD 4-/IP/bl
Signature Contractor's License No. Date
.~ t/N-vfJ:rI""';.
I Permit Fee I $ e~.? 0:;-
I Plan Check Fee I $ 54./1
I State Surcharge $ ~
L....~
I Penalty $' .
I Plumbing Permit Fee $
I Mechanical Permit Fee ~
I Sewer & Water Permit Fee $'
I Gas Fir'J1lrce Permit F~p $_
Ii ~--. I
I-.m -~-~
I Park Support Fee # $
I SAC # $
I Water Meter Size 5/8"; 1'" $
,
I Pressure Reducer $
I Sewer/Water Connection Fee # $
I Water Tower Fee # $
I Builder's Deposit $
I Other $
I TOTAL DUE ~ /38..50
4-,(. '01 $
I Paid /38.ev I Rec~.3441
I Date +-/O~O! By../j ,
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 an inspections (952) 447,9850, fax (952) 447-4245
PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INS'PECTION
RECORD
SITE ADDRESS ~"2-<,,=\ f),-u~ ~
TYPE OF WORK D~ r
USE OF BUILDING - _ It /2e:-s f}/1Z-.
PERMIT NO. (f) (~ZG.f) DATE ISSUED
BUILDER F~n~ {~r,
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
r I
41~lo,
INSPECTOR J DATE
, FOOTING I "'-l<.0/V4Of I dJ 01
PLACE NO CONCRETE UNTIL ABOVe HAS BEEN SIGNED
~ I I
(
, FINAL
I ~"'t I 6'/ /0) of
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
.'
. '.
.'
'"
'. ."
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/44;;.5' 'BllAP \o"r-cl
OWNER
s~io,
TIME
q~()O
PHONE NO.
CONTR.
PERMIT NO. /') I - .;l,fo ~
D FOOTING D PLUMBING RI
D FOUNDATION D MECH RI
D FRAMING D WATER HOOKUP
~.D,)NSULATION D SEWER HOOKUP
7I FINAL 0 PLUMBING FINAL
o SITE INSPECTION D MECH FINAL
COMMENTS: ~
--
o EXIGRADIFILLING
D COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
D GASLlNE AIR TST
o
/
/WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CDRRE~~~, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~tit}IJ Owner/Contr:
CALL 447-9860 FOR.J.E NEXT INSPECTION 24 HOURS IN ADVANCE.
\
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALffl " SAFETY!
lNSNOTI
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