HomeMy WebLinkAboutBldg Permit 01-1073
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
/4 ft;q~
Date Rec' d
f/- ){-o I
~. ~i~i~e ~::y I PERMIT NOY"'7/_ JAr?,'J
3. Yellow Applicant ( /f. /C/ I(,.J
6/ut/b/rd -r;~
ZONING (office use)
RISD
LEGAL DESCRLt'nON (office use only)
LOT / BLOCK a ADDITION k Noh
iJ-/I/
- ,
PIDdS- ,3/0 - Od I-D
(Phone)0/~- 1(P /- 5(;'-//
OWNER
(Name)
1l htU! He,(/ f}1tl1J
Sli/m~
(Address)
BUILDER
(N ame)
(Contact Name)
(Address)
TYPE OF WORK
o New Construction
~Lower Level Finish
o Misc.
(Phone)
(Phone)
ODeck
o Porch
OAddition
ORe-Roofing
ORe-Siding
PROJECT COST IV ALUE (excludin~ land) S
o Fireplace
OAlteration
OUtility Connection
$
$
$
$
$
$
$
$
1000.00
c2!LJ5
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
=ter~a?~~ectiOns. f'ls~ I
l t~re Contractor's License No. I' Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
Plumbing Permit Fee
Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
.50
.
'1{) .or)
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 # $
I Builder's Deposit $
lather ;5/:[gc electrie- fIr/' $ / ,00
I TOTAL DUE l'/tlh-cQ. q..W\ $ '1(,~;).5
'" .
'l~ .7 S ReceiP;t1lP <<;~
fri.?~.-tJ i By ,~-
I Paid
I Date
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
White - Building
Canary - Engineering
Pink - Planning
The Ctntf'r of Ihe takt ('ounlry
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT /); a j IJ~II hJt1/;LJ
APPLICATION RECEIVED q ,.. d-S-t:) I
,
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which ~ proposed at:
/t/69'- ~~
~
/l
Accepted With Corrections
Accepted
Denied
J
~
Date:
q~ 2[, ~o (
Reviewed By:
Comments:
P-e~ ~~~ \()W-fY \~ ~,^-\~f~ t\~.o~
"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
I .
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS ~ ~~,..& \\'1
NATURE OF WORK ~v..)& l-eu..J.. .c"'-l.~ 0 ') ~OOI.N\
USE OF BUILD~ .s F f)
PERMIT NO. - In'F!J DATEISSUED ct~2~-O(
CONTRACTOR e\ ~ PHONE..&l'2- -7t.-/ ~S~l./(
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
..,
/?;-:;.
~
111r#'/c I
l .
/I !a-~/cJ/
I
HEATING (if required) A //3/;;-
FIREPLACE .~. 1'/0 /~ Z;
GAS LINE AIR TEST r p. ~ I il b-sIo I
I
COVER NO WORK UNTIL ABOVE HAS BEEN SIt1NED
1 . I I
FINALS
BUILDING
ELECTRICAL
/1 t/}
5"-).0
HEATING
DO NOT
'"
j/t/}/./
OCCUpy UNTIL ABOVE HAS
NOTICE
This card must be posted near an electrical service cabinet prior to rough~in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
s- /),..0
BEEN SIGNED
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
.5;.)..0
ADDRESS
/tl~ t{ (,
1yl
Diu", b v' ~
OWNER
CONTR.
PHONE NO.
j - !()')?
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION} I
jj! FINAL vir....- t
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE R1
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
/' I _
/ 1 ())e
~
r'/ /
l-- I ~
,-WORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT V'~" CALL FOR REINSPECTION BEFORE COVERING
Inspector: fIr / S- '}O,()1 Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSlion
. -..]""-