HomeMy WebLinkAboutBldg Permit 01-0350
(Please type or print and sign at bottom)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
332.0 WOO f!L)
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER
(Name)
(Address)
1. White File
2. Pink City
3. Yellow Applicant
Date Rec' d
--0/
ZONING (office use)
eJJO
PID '25-903 - 010-0
(Phone)
~(Na~)'-'~ .~ CoVS T
(Contact Name) L e....c tV ~~J"'[ ~U
(Address) .., ? ., ~ ~ r1 / - ,.1
.:::. ^ ~_ ~ ~ ,..,w ~ " :;-t!J Vdo. cU
TYPE OF WORK
o Misc.
o New Construction
OLower Level Finish
(PhoneC95' 7-' tl-9 ~- ~-z.!j1J
(Phone)
M~. :5535:(
ODeck
~-&)onng
OAlteration
PROJECT COST/VALUE (exc1udingland) $
o Fireplace
OPorch
OAddition
~-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 uilding official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter u~:roperty to nee ed inspections.
X' ~ ~
- -,. j1yLA-
---.... ,-- Contractor's License No.
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
2, SOO,OO
$ 74. 1~
$
$ /'- ~s
$
$
$
$
$
Th~n Jrjomes Your Building Permit When Approved
ICAII~ 4'-/..4.-{l/
Building Official Date
Park Support Fee
SAC
#
#
. $
$
$
$
$
$
$
$
$ 7&;.00
-
Receipt Nf?t~ j '1 rt-
By !"
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
Water Meter 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
#
#
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
I Paid
I Date
'l{p.O'C
:f-'zk "0 I
I
DATE
Tit-~r
CITY OF PRIOR LAKE
INSPECTIOii ~OTICE
SCHEDULED
5-:3f5/
ADDRESS
~~~
~dd
I
OWNER
CONTR.
PHONE NO.
PERMIT NO.
J - 3 s-6
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
~rtJ ,)NSULA TION 0 SEWER HOOKUP 0 FIREPLACE FINAL
Jl!. ~~~AL 0 PLUMBING FINAL 0 GASLlNE AIR TST
o SITE INSPECTION 0 MECH FINAL 0
COMMENTS: [?esl Je.-- F f'J' - ~
fYJl~ ~~A~ (~
CC6.e
t>
S\l)INU
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION ~ND PROCEED
o CORR~II(, ( ALL FOR REINSPECTlON BEFORE COVERING
Inspector: ,~I CJ..;.;J{ Owner/Contr:
V I
CALL 447-9850 FOR THE IJEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI