HomeMy WebLinkAboutBldg Permit 01-0380
(Please type or print and siln1 at bottom)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1. White File I PERMIT NO
2. Pink City . .1")'1_
3 . Yellow Applicant / 1.
4044- etJ/lNOk..6 ,.J/Je6ET sE:,
LOT h BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION SP/2.INtj 8~alC- p/Jelt:-
OWNER A
(Name) !+N D '" ~A-fL~rJ
(Address) Lf OY Y Q OlhJO k.€- ~
PID ZS -()99, 004-0
(Phone) -3Sz.~~-'i~
BUILDER
(Name) F'ou/f!? SeA60NS
(Contact Name) LU JC,G
(Address) 3010 ~;V1t/6P/N /fV6.
TYPE OF WORK
o Misc.
o New Construction
OLower Level Finish
(Phone) 1dZ- ZZ/- f358S
(Phone)
S~TeZ70 ~540a
S. J npt-6 V
o Deck
~e-Roofing
OAlteration
o Porch
o Fireplace
OAddition
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~=(?erV;AedinSpectiOns. 2012 S ()~(p '1/'1D'"'a J O^,
Signature Contractor's License No. ~
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
PROJECTCOST/VALUE (excluding land) $
'2,500.00
$ 74.75
$
$ 1.25
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
Building Official
Date
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$ 7ft:,. 00
-
Receipt No. ~ '15.-1 u
By (JC ./
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"; 1";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE
I Paid
I Date
, 1ft:, . QO
_C; -/-0 J
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
t/ol/I ;2o~.no'e
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL ()
~e/oo-l-
COMMENTS:
~oP
.........1 -' I'
/ t'7~,Ile Ie.
DATE TIME
~#S~
&/-.3)/0
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
'~
.,,/ ~.r '. )
c/Os;e ~ /~ /
\ ~
~ ~ -----
r WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~~~~R ,REINSPECTION BEFORE COVERING
Inspector: j/ rv:~ Owner/Contr:
~-_...-,,-
,.../;-
//
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
UISNOTl