HomeMy WebLinkAboutBuilding Permit 01-0696
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1. White File
2 Pink Cily
3. Yellow Applicant
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'2 ~-O I
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{please type or vrint and sim at bottom)
/'ADDRESS
2. ~ ljO S f'1Ll1l1.o l...4-Ke: ~ I ,
ZONING (office use)
~/SD
LEGAL DESCRIPTION (office use only) tl
wr"'3 DBLOCK ADDITION JLJ.ii11;;; h1U:d---",ba LV
') ~ OWNER-.
(Name) f},rw,eL
PlD.:2'5- /3/- /) hi-o
(Address) 2(0 Cjo
L : (!,,"lIf)Y J( 3-o,..,"'>o,J
c S f^11t 10 LA1t..e: h
c..sJ - (,vy - 'JSOl- w
(Phone) $'S''l -I/o - K 2./., 7 -If
BUILDER
(NamF\
(Contact Name)
(Address)
(Phone)
(Phone)
DLower Level Finish
~eCk
o Fireplace
DPorch
DRe,Roofing
ORe-Siding
DUtility Connechon
TYPE OF WORK
o New Construction
DAddition
DAlteration
o Misc.
PROJECT COST IV ALUE (excluding tand) $
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 th t all construction will conform to all existing state and local laws and will proceed in accordance with
sub' ans. I am aware ~t the b "lding offi . revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
e r upon th roperty to p orm n ed insp 0
1 . f" 7-/~
-~ ~gnatur / Contractor's License No. { ~ ./
I Permit Valuation 2,..,., .e!>~ Park Support Fee # $
I Permit Fee $ l, t. '2.<; SAC # $
I Plan Check Fee $ "Ii c> ( I Water Meter Size 5/8"; 1"; $
I State Surcharge $ I . 00 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 GaSFirePla~P7FitFfe) $ I TOTALDUE~ 7-/(}.ol $ //5. Zro
/ J/VI 1/
fr:i7'" Be s uilding Permit When Approved : ~~~
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I Recei12tNoL..lD J('J J
By (r~---
This is to certify'rllat 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
..
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS ;).~C{O Spr,'V\O J?c..k. R.d-
TYPE OF WORK J:)orls::.. .z,., , ~/? '
USE OF BUILDING SF ()
PERMIT NO. ()/. 0 (0 q ro DATE ISSUED 7 -/~ - ~t'
BUILDER ~I..........'V,- PHONE # ~'S"/~ In<{c/- '1:fa7
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
[ FOOTING I ;;;ECTOR I 8/ q /;;
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I~ I I
, FINAL I <..\is...t\ a~ I 10/0 '/D'
Call between 8:00 and 9:00 A.M. for all inspedtlons f l
FOR ALL INSPECTIONS (952) 447-9850
DATE TIME
SCHEDULED ~)O: tl()
~~~,
, CONT'R!
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS ,;) (., ~ 6
OWNER
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
II-E.. INSULATION 0 SEWER HOOKUP
r-r ~FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MET, AL
COMMENTS: 2J~ ,... i
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1)/- ~ '1 fa
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
,
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO\!' CALL FOR REINSPECTION BEFORE COVERING
Inspeclor:~' 0^4 Owner/Contr:
CALL 447-9850 FORlTHE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/