HomeMy WebLinkAboutBldg Permit 01-0589
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please ~e or orint and si2ll at bottom)
ADDRESS /Li'3?(, A:?~e,... Ad., we
A\17r ,L.j;; .. AltJ S}3?~
White file
Pink City
Yellow Applicant
LEGAL DESCRIPTION (office use only) ~ I
LOTSBLOCK (:;, ADDITIONd:3y~ P {H~~
~':e~R ~At4/ t- (1,~{' _k.y /./""J
(Address)/~3'1(" -4.4fJUt Ave_ Nr=-
BUILDER
(Name' 9-aM,/" IJ n'=y L~
(Contact Na1I)e)
(Address)
14/3 7r.. A~ .4.-..
TYPE OF WORK
o Misc.
J.JE
t),--/z,,. ) ",~,
.#l/lJ
c;- 5'3? "
o New Construction
~eck
o Fireplace
-arci
~ -/J!-(} .
PID 2-1:' -,-:vL/~tJ5?-V
(Phone)
/215"1. )_tf01 - ~
'-- /
~,'3?.;L
11:.,.",.. L,,~~ lAW
,
(Phone)
(Phone)
DPorch
DAddition
DRe.Roofing
DAlteration
DRe.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-mentio ed operty that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted la m aware that . ding offici an revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon term e insp: 0
DLower Level Finish
PROJECTCOST/VALUE (excluding land) $
x
$
$
$
$
$
$
$
$
I. '100 . ()() I
(J.o. zo I
d 7, ./')~ I
. q<:..- I
I
I Permit Valuation
I Permit Fee
I 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
/~ ()
/"./'J i~ytrfJ ecomes ~~Uilding Permit When Approved
(flyf!, 7 ~-Itl-Z=I
Building Offi . I Date '
Contractor's License No.
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
\ Builder's Deposit
I Other
l TOTAL DUE
~/
Paid I/O / /11'
Date (, / /9 /()/
If
#
#
#
#
~/3, 01
Date
$
$
$
$
$
$
$
$
$ I/()./~
~-
I Receipt No~ 'IX ~
Bv ~
U
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 honr notice for all inspeetions (952) 447-9850, fax (952) 447-4245
'"
PRIOR LAKE
INSPECTION
RECORD
Av~_.
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS .IY37f.t, A"r~1I\
TYPE OF WORK J)ak-
USE OF BUILDING SF{::J
PERMIT NO. ()!- 0569
,
BUILDER Luvv::l 463-7'(,-0 ~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR DATE
I FOOTING I ~ \\~ I t., ~O\ b\
PLACE NO CONCRETE UNTIL ABOVE lttAS BEEN SIGN~D
l~ I I
DATE ISSUED
t..-I'/-c,q
I FINAL
~ r I 7/#./0/
I
Call between 8:00 and 9:00 A.M. for all Inspections
FOR ALL INSPECTIONS 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
TIME
'/'-;(-{) ) J1- -;:
~~
DATE
ADDRESS
It! 37~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
I~~LJ
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING CB 0 WATER HOOKUP
o INSULATIOND V ~:.. 0 SEWER HOOKUP
.-B""tiNAL "- f" 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL .
.~
,
o EX/GRAD/FILLING
o COMPLAINT
/X 0 FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
( ~.~.
~I
Ii
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~ ( Owner/Contr: "'"
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN~VANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl