HomeMy WebLinkAboutPermit 01-0870
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
-#1.' S--,~~k/1'1./
I
LEGAL DESCRIPTION (office use only)
LOT} BLOCK I ADDITION ?;~~
Date Rec' d
I. White File
2. Pink City
3 . Yellow Applicant
IZL/&l: ~
/Ve-
I}/,b~ -I; 4 ~ 4u ,'JS-:J5F-()()3 - c,
, -
(Phone) 9:>2-77~-Y5s9
. .
OWNER t _"A.-.} 1_ I
(Name)~h f/V~tL€JeIVtS
(Address) 4It?b) ~k~~ ~ Re> tn.
/
BUILDE~ L ~ ~_ /. fYI'/#, . ~
(Name)~S. /~37~~ /P1;t7~~ h.?(Phone)v>7~ ~7I--J~
(Contact Name) _~ ~ ~U~ ~ (Phone) t;;j;'?-~7lJ(Jg
(Address) ~z::J88' ~I Un.c-
TYPE OF WORK
o Misc.
o New Construction
OLower Level Finish
~eck
o Fireplace
OPorch
ORe-Roofing
OAddition
OAlteration
~~
ORe-Siding
OUtility Connection
I 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
sUbmitt;:nP;~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
;teru/t'~e~~ns. ~007~~ f-Jr-Cj
Signature . Contractor's License No. Date
. Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
PROJECT COST IV ALUE (excluding land) $
2, c)oo .Oc":)
{,'.Zs
'-IK. 0 (
I..~
.
.r?QatiOO~YOmB-:~:-=d
\f" e,..... Building fficial Date
I Park Support Fee
I SAC
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
I TOTAL DUE
I Paid
I Date
J/},~(e;
~ ~/-Jj).().'
#
#
#
#
$
$
$
$
$
$
$
$
$ / /5. 2-b
.-/
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 tempOfaty 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
White - Building
Canary - Engineering
Pink - Planning
The ('rntrr of Ihe t.kt Counlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
..---;-'
NAME OF APPLICANT (fJ&J:s oJ-./)~S is10 Jnl,pro Ue.--fYLC/U +-S
APPLICATION RECEIVED ~ - ) ~ -0 /
The Building, Engineering, and Planning Departments have reviewed the building permit
application fo:;~~u;n,R:;=oMI~ d
· 0 0
Accepted With Correctio'X
Accepted
Reviewed By:
Date: ~ - r~-",. Pa::9/
,/
Denied
Comments:
~.~ ~ !I..-~
"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or of any other ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
'"
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS 3a::'5 ~~. f?J4,. ~
TYPE OF WORK --I::Pc[('
USE OF BUILDING .s~0
PERMIT NO. Il/- OB70 DATE ISSUED 8 ,.(S-~(
BUILDER ~\::. ~~~r'4~ ~ . PHONE #.Q:>7 -(,2~- ~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR DATE
, FOOTING I #J:r I f/ Zl/ D /
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
<fIRAMING ~~ l"'sI.Lt.~ ~L~ I ~ I ilc9-//tJ/
'ek
~ FINAL
e~'Z't.c:1\
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED A~ 1.'1."'0 l
4+
ADDRESS LfO(Pt:::;"" e.a..~~ ~
OWNER CONTR.
PHONE NO,
PERMIT NO.
I - $5 /0
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HO
o INSU~N {@ 0 SEWER
)!t..FINAL ~<: lC "k 0 PLUMB
o SITE INSPECTIO. 0 MECH
COMMENTS: C
~L-
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/
'WORK SATISFACTORY, PROCEED
o CORRECT ACTION ~PROCEED
o CORRECT WO.rt \L FOR REINSPECTION BEFORE COVERING
Inspector:!fL-, _ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl