HomeMy WebLinkAboutBuilding Permit 01-0434
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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LEGAL DESCRIPTION (office use only)
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BLOCK 3ADDITION
I OWNER
(Name)
(Address)
B ro..d I e- 'i
Date Rec'd
5-//-0/
1. While File
2. Pink City
3. Yellow Applicant
I PERMITNO'OI_O./34-1
I ZONING(officeuse) I
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(Phooo) q".;> - 13" - "''I ,;; 9
BillLDER
(Name)
(Contact Name)
(Address)
(phone)
(phone)
TYPE OF WORK
o New Construction
~ck
o Fireplace
OPorch
OAddilion
ORe-Roofing
OAlteralion
ORe-Siding
o Misc.
DLower Level Finish
PROJECTCOSTIVALUE (excluding land) S
OUtility Connection
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 loca1laws 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 pro to perform eded inspections.
Your Bnilding Permit When Approved
x
Signature
Pennit Valuation
Pennit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Pennit Fee $
Gas Fireplace Pennit Fee $
Contractor's License No.
/t~a
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/811; lit; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ /.3A. Ah
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I ReceiptNo. 3.,Go'Z"l
By ~(> 14
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 temporary Certificate of Zoning compliance and allows construcywn 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
INSPECTION
RECORD
SITE ADDRESS 46'ft,Z SCA~UlA__ el R-.
TYPE OF WORK ~L
USE OF BUILDING . .4'/ /Z..
PERMIT NO. 01- 0434- DATE ISSUED 5 -11-0 1
BUILDER o//t.e/A/ PHONE # 1533 -~2-
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
,
FOOTING
PLACE NO CONCRETE UNTIL ABOVE HAS BEE
I FRAMING I I
I FINAL I ~ I '3.~ -o1--l
" Cal/ between 8:00 and 9:00 A.M. for aI/Inspections
FOR ALL INSPECTIONS (952) 447-9850
I ECTOR DATE
"
. .
CITY OF PRIOR LAKE
INSPEcnON NonCE
SCHEDULED
ADDRESS
'1(&)
~t"4(V i / /, ~
-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL nole...
o SITE INSPEC'llON.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
a SEWER HOOKUP
a PLUMBING FINAL
o MECH FINAL
COMMENTS:
DATE TIME
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01-04"]/../
o EXlGRADlFILLING
a COMPLAINT
o FIREPLACE RI
a FIREPLACE FINAL
o GASLINE AIR TST
o
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~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~ FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNCm
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI