HomeMy WebLinkAboutBldg Permit 03-1256
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File
2. Pink City
3. Yellow Applicant
I PERMIT NO. tJ 3 -t;254
(Please type or print and sign at bottom)
ADDRESS
/(P f~ 7
81:nd ~7/e 5_ E;
ZONING (office use)
LEGAL DESCRIPTION (office use only) ,()
LOT g BLOCK 5ADDITION ,~~
PID;;;5-011- octo-C)
OWNER
(Name)
w4-
&,u-t/~
(Phone)
<to:;' W7-/7~
(Address)
(Address)
~ ~ ~ 1/_1'
" ~ 'JLU J~ T/~LtIUv0XJ[I7jY'
~ABC Seam leSE
355 21 st Street
Newport, MN 55(\J;~
u.-~l V I AI /, rill"
(Phone) 'IJ 6/ 1 fj B'uK 'f''f
BUILDER
(Name)
DLower Level Finish
o Fireplace
OAddition
OAlteration
ORe~tng ')5b~
DUtility Connection
TYPE OF WORK
o New Construction
ODeck
OPorch
ORe-Roofing
o Mise,
PROJECT COST/VALUE (excluding land) $
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 d that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted P~;~ilr am aware that the building 0 al can revoke this permit for just cause, Furthermore, I hereby agree that the City offiCial or a deSignee may
enteru~on/};;;?Z ed 'n cti ns. 1'770 9 _ /1-113
r /. S,,,,,.rure ~a) CMtr"'~', Li=" No. DM<
~/ - I~
I Permit Fee $ r -:ff:f .,. 7/.{ I!: . I Park Support Fee # $
I Plan Check Fee $ I . C)~ I SAC # $
I State Surcharge $ I Water Meter Size 5/8"; I"; $
I Penalty $ I Pressure Reducer $
Plumbing Permit Fee $ I Sewer/Water Connection Fee # $
Mechanical Permit Fee $ I Water Tower Fee # $
Sewer & Water Permit Fee $ I Builder's Deposit $
I Gas Fireplace Permit Fee $ I Other $
$ 7&.---
This Application Becomes Your Building Permit When Approved
TOTAL DUE
I Paid IftJ,-- ReceiptNoL/~ ~/r? q
Building Official Date I Date 1- ~-:2> By &1.- ( I
. /J
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and m~roceed 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
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
<-i'A~5'-
/t;?b7 /?~~ c-/ ~/e
.
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
...e-FINAL
o SITE INSPECTION
COMMENTS:
/J ,,/
/ce~,de
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
til -Os-(
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
./? I /
Co~;4 I e r-e
"
~ ~---",
/0;'s-e 4~--)
'- \ ~
X WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
lNSNon