HomeMy WebLinkAboutBldg Permit 01-0415
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White File
2. Pink City
J . Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
11../ I i..J 0 ~ Sa-V // I ~tU (! J J-.
I
LEGAL DESCRIPTION (office use only)
LOT 3 BLOCK ~ ADDITIONf1OJJ /J i ew fl-ck[/lJ
Date Rec' d
j- g-O/
PERMIT NOO/.... '/IS
ZONING (office use)
7</50
PID;E' --I JS?'" (J)() 7-2)
(Phone) q 5 )--lfL/s -;;).J S C::,
OWNER
(Name)
P~+Y'/1Cltl p~+er~.o-r--J
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
(Phone)
(Phone)
o New Construction
~e-Roofing
DAlteration
ORe-Siding
DUtility 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 cit'.( official or a designee may
~te~erform~~ffi 5 ~ () \
Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
o Deck
o Fireplace
OPorch
DAddition
DLower Level Finish
PROJECTCOST/VALUE (excluding land) $
$ -tlf, /5"'"
$
$ l ~S-
$
$
$
$
$
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid ;;{ l/o, 00
I Date -4f' t:;= q.-- (') I
This Application Becomes Your Building Permit When Approved
Building Official
Date
# . $
# $
$
$
# $
# $
$
$
$ '!(P.OO
Receipt No. ,~Cf' t;~.t:;
By CJC- ~
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
DATE
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUL~D
5'2ft} I
E;A \j l/ l~~LU
I
A.T
ADDRESS
I 4-14-r)
OWNER
CONTR.
PHONE NO.
PERMIT NO.
() 1- o4(S-
o FOOTING 0 PLUMBING RI
o FOUNDA nON 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION r::i 0 SEWER HOOKUP
FINAL (2..001-/ 0 PLUMBING FINAL
COMMENTS_, - . .....,....- '.
C. ,.,......-,..'.~(?1- () 1.:.# - ) (~~
,. ~ ~fr. Tz.--( e.-
-~--.__.
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
)
'pcWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~J
I
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI