HomeMy WebLinkAboutBuilding Permit 01-0404
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec'd
L White File I PERMIT NO
2. Ph,,, Ci" . I A
3. Yellow AppliCUlt t:J --re:>"
~1ease!VDC! or mint and silm at bottom)
ADDRESS
ZONING (office use)
elsD
HJ)\~O
WestJ\.'Ie
SE-
LEGAL DESCRIPTION (ollice use only)
LOT Q. BLOCK 1 ADDITION
Lnh:s\Ae GorAfV15 ~ M\'tJ PID 2.5-2-11- 00 2..-()
OWNER \ \ '"'0_ V '
(Name) ~(C\ (lnn "'V~ea..n("\ mr f\. In Yl ~
(Address) \In\~ P'~,:\Je. SS'_
(Phone) -9,5::J - '1l1?- , ?:9 5..3
BUILDER
(Name)
(Contact Name)
(Address)
(phone)
(phone)
)l{Deck
TYPE OF WORK
o New Construction
oLower Level Finish
oPorch
oRe.Roofing
oRe.Siding
o Fireplace oAddition oAlteration oUti1ity Connection
PROJECfCOST/VALUE (exc1udingland) S ;;) Pi:X). 00
o Misc.
I hereby certify that I have furnished information on this application which is to the best of my knowledge hUe and comet. 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
;~;;':;'l7;kI/;'~ -c;/4 /r) I
Signature - - {i Contractor's License No, 'Date
I Permit Valuation
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 FiIep;5)permit ~ee I
This . s
l..rno-
c.."f. ,'2 S
"'$.01
1.00
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
$
$
$
$
$
$
$
$
$ 1I S. 2."
#
#
$
$
$
$
$
$
$
$
#
#
I Paid
I Date
1\ S. '2.-1.-
... -'t-O
iJf-7
Date
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 l_....._......J 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 fnr all inspeelions (952) 447-9850, fax (952) 4474245
"
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS (~ \f50 ~l A vG
TYPE OF WORK f)~ .
USE OF BUILDING rz.es ~/fz... ,I
PERMIT NO. 01- ....e>4 DATE ISSUED S /~ /0 ,
BUILDER ~~~S~"''''''IU tvlc.K'N"'~ ... .
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING I ~-\)aPq I ~1I,,'OI
PLACE NO CONCRETE UNTIL ABOV~ HAS BEEN SIGNED
~ I 1
I
, FINAL
.4
I @r; 11//1/111/
. I .
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 I (p / 36
oJ.f2.4;t- ~,
OWNER
CONTR.
PHONE NO.
PERMIT NO.
Cl FOOTING
Cl FOUNDATION@)
o FRAMING
Cl INSULATION ,
~ FINAL
Cl SITE INSPECTION
Cl PLUMBING RI
Cl MEcH RI
o WATER HOOKUP
Cl SEWER HOOKUP
Cl PLUMBING FINAL
Cl MECH FINAL
COMMENTS: d)eu..:.....
'-
/"
.~
\
I
I
;
/
DATE TlIIIl
71/(,,/0 I
f
A. 7'
0/ - l/J()'f
Cl EXIGRADIFILLING
Cl COMPLAINT
Cl FIREPLACE RI
Cl FIREPLACE FINAL
Cl GAS LINE AIR TST
Cl
~
/'
/
/
~RKSATISFACTORy.PROCEED
Cl CORRECT ACTION AND PROCEED
Cl CORRECT WO~LL F~R REINSPECTION BEFORE COVERING
Inspector: ~ ~ Owner/Contr:
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNV<<JrI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/