HomeMy WebLinkAboutBldg Permit 01-0561
(Please f.1(P.e or urint and sign at bottom)
ADDRESS
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yellow Applicant
rC,e6S-r ute S"t::.-.
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
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e) 6 ~1 .....2ft"S S
(Address) ISd.d. 0 ro/~~) uie..
BUILDER
(Namp\
(Contact Name)
(Address)
TYPE OF WORK
o New Construction
o Misc.
DLower Level Finish
PROJECfCOST/VALUE (excluding land) $
Date Rec'd
(p. '0/
ING(officeuse)
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PID Z5~//PS- 002..-0
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S.F.
(Phone)
(Phone 11
;%Deck
o Fireplace
DPorch
ORe-Roofing
DAlleration
ORe-Siding
DUtility 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 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
enter upon the property to pe needed inspections.
X T~-'
Permit Valuation
Permit Fee
Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
30OD. -
S'2>.2'5
54.11
1.0:;0
This Application Becomes Your Building Permit When Approved
Building Official
Date
DAddition
#
#
t,-~I
- ~ate/
$
$
$
$
$
$
$
$
$ 13B. gG::>
Contractor's License No.
Park Support Fee
SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid /.38 ~6
I Date (, '(p. Of
#
#
. ~
I ;gttNO'
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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
PRIOR LAKE
INSPECTION
RECORD
Isz2.0 Faz.tZsr C,R.
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
TYPE OF WORK
USE OF BUILDING
PERMIT NO. FJ I ~ sr~ f
BUILDER C::>Lt:.N ~A$~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
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DATE ISSUED
, .
(../&0(01
!SPEr:rOR DATE
'FQOTING I e;;r I ~(fq( D I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
~ I I
I FINAL
~
I
I 9f""J ( Z31nt
, .
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
SCHEDULED rz(-z >:,(tJl
~ ('t'L,
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATIO;,@N
o FRAMING
o INSULATIO
~ FINAL
o SITE INSPECTION
o PLUMBING RI
o MEcH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:7)c~
~l
~
~.
Ua-6.1 ...
V
OA TE TIME
A"
()/ -c: en f
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
)
,
~ WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~All FOR REINSPECTlON BEFORE COVERING
Inspector: - ~ ( Owner/Contr:
J
CAll 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!