HomeMy WebLinkAboutBldg Permit 05-0821
(Please type or print and sign at bottom)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
Bo Z3.0~
I. White File I PERMIT NO I
2. Pink City . 05'~ 0 ~z.1
3. Vellow Applicant 0
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LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER .
(Name) /11/", e/~'t;'y,da.. !
(Address) /~S7. ~
ZONING (office use)
PID ~ '2-8(0. 0 fB" 0
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LCA-YI (/1_
PrJ'or L..:;. kt=>
(Phone) -'i.,"):J. ~ t.t!i/) - ~ <L36
BUILDER
(Name) n1 In" e.s./'rI-4 I;""yl-er/(u~..<;
(Contact Name)
(Address)
<? (;,00
TYPE OF WORK
o Misc.
(Phone) 76_ 1- Llt[? -~~()lJ
(Phone)
~ ~WGr.sOr} Jtwy
,
Os s er,
117J1
~'i- :'69
~e-Siding
OUtility Connection
OAddition
.
PROJECTCOST/VALUE (exc1udingland) $ 12 <140
,
~-a877
Contractor's License No.
$
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I WaterMeter 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
o New Construction
o Deck
o Porch
ORe-Roofing
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 perform needed inspections.
X ~4- ;'gnature
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
OLower Level Finish
o Fireplace
OAlteration
I Paid
I Date
7~.UV
8. z+" dJ~
This Application Becomes Your Building Permit When Approved
Building Official
Date
~~~
Date
# $
# $
$
$
# $
# $
$
$
$ 'lfQ. c>o
Rec;r:o, ff'94-
By .
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 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
{"'.~
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SCHEDULED
DATE TIME
I d-~'{-a-
ADDRESS
IlIS7> C.d/Y1~- ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
J<;'d/~
Q AJ~
411
J-+vu.s-t"
S:~2 {
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
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9. ~K SATISFACTORY, PROCEED
<<CORRECT ACTION AND PROCEED
o CORRECT W~RK~R REINSPECTION BEFORE COVERING
Inspector: ViI I -- Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSliOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!