HomeMy WebLinkAboutBldg Permit 01-0799
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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, YeUow Applicant
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ADDITION
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(Phone) 95"'2- 'I~S-"" ~ 7~3
tV 000 ST.
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LDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
eck
OPorch
OAddition
ORe-Roofing
ORe-Siding
OLower Level Finish
o Fireplace
OAlteration
OUtility Connection
o Misc.
PROJEer COST IV ALUE (excluding land) S
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
orized 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
su 'tted 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 property to perform n e d inspections. . /
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Contractor's License No.
Date
Permit Valuation ,
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
$
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ (p~ 1./3
<;lJJ..,
I Paid
Date
I Receipt No. 4Cfr?
By ~
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 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
P RIO R ~A K E ~~rtD~~~~r:JD ~~SPECTION
INSPECTION
RECORD
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PERMIT NO. O(-"1'l1 DATE ISSUED 7/~/Of
BUILDER .oS-rESW A~-SAM l, 4-~.. +/'2--3
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
SITE ADDRESS
TYPE OF WORK
USE OF BUILDING
INSPECTOR DATE
I FOOTING I b V ' I 7-3t!J -e/
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
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I FINAL
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Call between 8:00 and ,9:00 A.M. for all Inspections '
FOR ALL INSPECTIONS 447-9850
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ADDRESS
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TIME
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DATE
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING ~ 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION /I" 0 SEWER HOOKUP
~INAL f----f] PLUMBING FINAL
-0 ~E INSPECTION 0 MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
l61WORK SATISFACTORY, PROCEED
r;; CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
'"pedor. ~, OwnedContc
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
INSNOTl