HomeMy WebLinkAboutBldg Permit 01-0349
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ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White File
2. Pink City
3. Yellow Applicant
/:3geS P/)::..~ ?/iK.-C 7l2I11t..--
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
PID ZS '923 - 001- 2-.
OWNER
(Name)
HllLfS VIER-UNCI
,
(Phone) 'I'{5 -0 d8'"2.
(Address)
BUILDER 1~JJ.
(Name) .~-) .QUU~
(Contact Name) ~
(Address) 3fogwt!).(Jd U. :S~nI
TYPE OF WORK
o Misc.
Date Rec'd
4-,-~..o /
~,..
'(;/-~34q
. I
ZONING (office use)
,4-1
(Phone) 'IS). - y,~.. - JPl.{cJ
(Phone)
o New Construction
ODeck
o Porch
OAddition
~Re-ROOfing
OAlteration
ORe-Siding
OUtility 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 ~erform needed infections.
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Signature Contractor's License No. Date
I Permit Valuation
Permit Fee
Plan Check Fee
I State Surcharge
I Penalty
Plumbing Permit Fee
Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
OLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
2,575D.00
$ i ~4-.'1S"
$
$
$
$
$
$
$
Park Support Fee
SAC
#
#
-
Water Meter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
Water Tower Fee
#
#
/.2.5
Builder's Deposit
I Other
I TOTAL DUE
Paid '7 (;p .([7)
Date/:a..7A ...p I
$
$
$
$
$
$
$
$
$ 71;,.00
I
Rece.
. By llr/"
This Application Becomes Your Building Permit When Approved
Building Official
Date
3'13 'I z..---
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/3??) /?Xe ~~e
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
COMMENTS:
4 r
/~ roo t-
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
r;~// ~ I~
~ ,
"_.-.._-_.-"~-
DATE TIME
I/>>/as-
/ r
o/-.1>Y7
o EXIGRADlFlLlING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~
(;~;:Se h/~~ )
~WORK S~CTeRY, PReee",u ----
o CORRECT ACTION AND PROCEED
o CORRECT WORK, :~: F3rE~PECTION BEFORE COVERING
Inspector: ~ ~ ~ Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTl