HomeMy WebLinkAboutBldg Permit 04-0038
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
L White file
2. Pink City
3. Yellow Applicant
/- d- "d-oy
I PERMIT NO. (j 4 - () 0 3f
(!>>lease ~ or 'Print and sip at bottom)
I ADDRESS
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LEGAL~SCRIPTION(OfliceuseOnlY) (7. . ,
LOT g BLOCK / AUUlltON .J,;tiJ ~f
. 0
OWNER \
(Name) _ J"",(.-</ /J? r. c A. 4> / R j '--
1M, //j----cjJ IjJ~ d5-36'7- 6'i{lj-')
J
(phone) 9'~-2 - C;; a ~ - s-a -";'
(Address)
~c: 4:$
Co"f~ v-e
BUILDER
(Namp) . 5~...,-'t"'"
(Contact Name)
(Address)
CL-5
hu_;/~"'A -
(phone)
(phone)
TYPE OF WORK
o New Constroction
ODeck
OPO.m
ORe-Roofing
ORe-Sidmg
DLower Level Finish
o Fireplace [JAdditioo OAlteratioo OUtility Coooectioo
PROJECTCOSTtVALUE (exclo<lingland) $ /~C _ ..,rYOO
~ Misc.
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 constrnction will conform to all existing state and loca11aws 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
~~iliZL7OOO~d~ #~/~7
~ SiJmature -> Contractor's License No. Date
I Permit Valuation ~t:f 00. ()O I Park Support Fee # $
I Permit Fee $ fl'z..S;Ot:l I SAC # $
I PlaoCh""''' $ It,,ZS I Water Meter Size 5/8"; 1 "; $
I StateSurchaile $ ,50 I Pressure Reducer $
I Penalty $ I Sewer/WaterConnection Fee # $
I Plumbing Permit Fee $ I Water Tower Fee # $
I Mechanical Permit Fee $ Builder's Deposit $
I Sewer & Water Permit Fee $ I Other $
I Gas Fireplace Permit Fee $ I TOTAL DUE $ 4-/. "75"
II
. This Application Becomes Your Building Permit When Approved I Paid 4-/, 7S I Receipt No. 4-(,2- Z.8
~ ~ I/.)~/() 'I I Date I ZJ. {)4-- BV /..- \
() I,
Building Oflicial Dale
This is to certify that the request in the above .......:.:..........:__ and aa:ompanying ~_ w__ .~... is in accordance with the City Zoning Ordinance and may proceed il5 requested. This document
when signed by the City Planner constitutes a .~...t- ..~~. Certificate ofZooing compliance and allows construetion to commence. Before oocupancy, a Certificate of Occupancy must be
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Planning Direcror
Date Special Conditions, if any
24 hour noliee for aU iusoectlons (952) 447-9850. fu (952) 447-4245
..
PRIOR LAKE DEPARTMENT OF
. BUILDING AND INSPECTION
! NSPECTION
USE OF BUILDING ~r:::. 0 .' .
PERMIT NO..oJl'~ tr DATE ISSUED /-:Ad.-"&,(
BUILDE~.-nt i G," a.1'e.-+"2.- PHONE #-.!10 3 - S()~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
SITE ADDF 3S
INSPECTOR
DATE
,... I I
PLACE NO CONCRETE UNTIL ~F!OVE HAS BEEN SIGNED
iFRM,,:!NG I PIS .~.~ I
I /
I ~/Z'5(()Cf
I .
FOR ALL INSPECTIONS (952) 447-9850
I FINAL
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(If! 'J
.,----_.-,._--_...._~_._..,~._--_.,-~-- '"---. ---.-.-..-.... ..'-
DATE TIME
CITY OF PRIOR LAKE ~ 1,,11.,,(
INSPECTION NOTICE SCHEDULED"~
ADDRESS (4QY'S S't>IW-\N\.: ~ 0.~;.-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
q- ~t
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
~~~ V:-' ~>-l
~ORKSATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o COil.~.~~"K' CALL FOR REINSPECTION BEFORE COVERING
Inspe r: Owner/Conlr:
"
CA _ 50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
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