HomeMy WebLinkAboutBldg Permit 01-0366
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ADDRESS
JJ9(,
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White File
2. Pink City
3. Yellow Applicant
Date Rec'd
PERMIT NOO/_ 03~ ~
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St
LEGAL DESCRIPTION (office use only)
LOT 5BLOCK ADDITION PrIor {JJCJod
OWNER
(Name)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
. (Phone)
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(Phone)
(Phone)
P.rt>" / 'rr Ie. M t'I
TYPE OF WORK
o Misc.
PJ.
1: J~-...
ZONING (ofticeuse)
R I 51J
PIDc?5" - I () 3 - CJO C::,- 0
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<;S-..2 - ~<t..l' 9<t71
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
~ter upon the prcr~~e~:1;d inspections. J 'J.) 7 L..J ~~ I., '0 ,
U Signature Contractor's License No. Date
J~", r-...~V \\" \~AAI' t
,
J~q(p ~~r '.~.
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
o New Construction
fERe-Roofing
o Deck
o Porch
OLower Level Finish
o Fireplace
OAlteration
OAddition
PROJECT COST IV ALUE (excluding land) $
$ 7L/ '/~
$
$ /, d-~
$
$
$
$
$
I Park Support Fee
I SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
I Other
I TOTAL DUE
I Paid tllp' no
I Date ' IJ- ~-o (
,
This Application Becomes Your Building Permit When Approved
Building Official
Date
#
#
#
#
$
$
$
$
$
$
$
$
$ 17~,o0
_.,-.. .-11
Receipt No. :5 -J .J-II
By CCf' J
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~C}~ /(eA/-J-
OWNER
CONTR.
PHONE NO.
PERMIT NO.
DATE TIME
~:J-o,l ,J ;3D
O/-3~0
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o JN5ULA TION 0 SEWER HOOKUP
.2 ~!~~L 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS(/~ <<?16 [W~ /~3D)
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/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTI<\N AND PROCEED
o CORREC~ORK\ CALL FOR REINSPECTION BEFORE COVERING
Inspector: '..D..,\ ~ Owner/Contr:
CALL 447-9850 FOR Tt.E NEXT INSPECTION 24 HOURS IN ADVANCE.
~ .
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!