HomeMy WebLinkAboutBldg Permit 01-0448
(Please type or print and sign at bottom)
. ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
J. y.now Applicant
Date Rec' d
PERMIT NO. 0'1-
1'/1J{) 0/e-AJda Ie /I- (/~
LEGAL DESCRIPTION (office use only)
LOT (PBLOCK I ADDITIoN1?akla.)Jd &~ B/Jd
OWNER -;
(Name) '--.J e.-r;- '/
I
(Address) . \1l..h1 e..-
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
MtLho)V€-v
I
PIDd5- /3~ - OOh-a
(Phone) Ljt/?-ql):J")
(Phone)
(Phone)
o New Construction
o Deck
ORe-Roofing
~e-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
enter u n the property to}?erform n~ed in.,! spections.
~ Y-/.5-..tf/(
/ Sign~./'/
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
OPorch
OAddition
OAlteration
OLower Level Finish
o Fireplace
PROJECT COST/VALUE (excluding land) $
Contractor's License No.
$ 7'-/" I~
$
$ 1/;;L5:"
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
7fo .0 V
S//~O!
Building Official
Date
#
#
#
#
Date
$
$
$
$
$
$
$
$
$ r)it, .00
Receipt No..~ Cj':J 3 'tI
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
-.--.-..--.----,.-.-.--.... .
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
SCHEDULED
5-24-'0/ ,4. i.
ADDRESS
/4720 6LEfJO/fLE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
01- 044-8
o FOOTING
o FOUNDA nON
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
.LLB. GASLlNE AIR TST
n ~ ~-Sl{)b
COMMENTS:
~
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, tALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ c/\..~ Owner/Contr:
CALL 447-9850 FOR T~E NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENls ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI