HomeMy WebLinkAboutBldg Permit 01-0621
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yellow Applicant
Please e or
ADDRESS
LEGAL DES RIPTION (office use only)
{ , -----
LOT BL CK S ADDITION
OWNER
(Name)
I 0k Lu-~
1'-../
I
i
(Phone)
(Address)
(Phone)
(Phone)
BUILDER
(Name)
(Contact Nal')
,
(Address) I
'1;'9/1 ,6cu'lde/5 ~"-
,fift- /n/fUJ'
,
/3>72-J Jh, y !. /:)J'[
d~
TYPE OF WORK
o New Construction
Deck
DPorch
DAddition
DLower Level Finish
o Fireplace
o Misc.
PROJECT COST IV ALUE (excluding land) $
Date Rec' d
PI
5 30;< -t1IIt.~
6/z-Y..t2-
t:fJo-u
MeN
5-733
ORe-Roofing
ORe-Siding
DAlteration
DUtility Connection
I hereby certify at 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 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
;teruponthepr pertyt 0 ne~;::. ;).0/ J 0177 6-~ -iJ 1
SIgnature Contractor's License No. Date
Permit Valuati n Park Support Fee # $
Permit Fee $ SAC # $
Plan Check Fe $ Water Meter Size 5/8"; 1 "; $
State Surcharg $ Pressure Reducer $
Penalty $ Sewer/Water Connection Fee # $
Plumbing Pe $ Water Tower Fee # $
$ Builder's Deposit $
Sewer & Waten Permit Fee $ Other $
,
Gas Fireplace ermit Fee $ TOTAL DUE $ (p
I Paid I~ :[~O f l~tA7
Date
This is to certify tlW 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.
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Planning Director
-L-~~_
~ PfllOR LAK"E
I INSPECTION
I RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
I I
~/zd pI
. .
l!!rAL
CITY OF PRIOR LAKE
INSPECTION NOTICE
~CHEDULED
DATE TIME
7-Z-J.IJ!
!y<f1)
ADDRESS
.6507 C/UJJ'S/1 /vZJe!1
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING @
o INSULATION
KfINAL
(0 SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
0(-0(. '2-/
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
~cr(.
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: q , Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
lNSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/