HomeMy WebLinkAboutBldg Permit 01-0356
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White File
2. Pink City
3 . Yellow Applicant
(Please type or print and sign at bottom)
ADDfE~~ ? 7
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LEGAL DESCRIPTION (office use only)
/~ IS-
LOT BLOCK ADDITION
OWNER /
(Name) I ~ "f?. -.e..
(Address) 4-)1 ')
BUILDER ~ " J
(Name) ILd/Vl A.....,
. {
(Contact Name)
s
e- u e P2..-
(' t? / 01"(;1 do
,
La. VI ~ k.e~ I-
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(Phone)
(Phone)
(Phone)
(Address) Lf3 Cf~.. 7Jt4#-()~
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TYPE OF WORK
o Misc.
'd
ZONING (office use)
R-d-..
PID dS''''OO/- /11-0
Lrl/7- ~J ~~
.
Yt.;/- 29 ~
OLower Level Finish
te- ooting
o Fireplace OAddition eration
PROJECTCOST/VALUE (excluding land) $ ~ I
OUtility Connection
o New Construction
DDeck
o Porch
ORe-Siding
--
I hereby certify that I have fu ed 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 r the ab e- entioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted pi am a that the build~Qfficial can revoke this permit for just cause. Furtherm~re. I hereby agree that the city official or a designee may
=terupon rope ~mspections. &11 Nf L(2St-6/
V Signature Contractor"s License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$ iL{, IS-
$
$ I'a~
$
$
$
$
$
I Park Support Fee
I SAC
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
I Other
I TOTAL DUE
rj(p ,OD
I..f- d.S-01
This Application Becomes Your Building Permit When Approved
I Paid
I Date
Building Official
Date
#
#
#
#
$
$
$
$
$
$
$
$
$ r;t"oO
By
-
Receipt No. :3 9 .3 'f' '-f
~
I 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
UAIt: IIMt:
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
f;M- 0/
A .1.
ADDRESS
4537 COt-O~OO !=/.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
1-3.50
o FOOTING
o FOUNDATION
o FRAMING
~NSULA TION r:::
FINAL ,e6?)r
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXlGRADfFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
-
('f'~ ~tJt7
)I WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOR~LL F~R REINSPECTION BEFORE COVERING
Inspector: r7 -71 Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
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