HomeMy WebLinkAboutBldg Permit 01-0488
(Please type or print and sign at bottom)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White File
2. Pink City
3 . Yellow Applicant
/5489 (JM€-Giri //L
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION /'1~GS 2 N b
OWNER
(Name) -----A(i...Utli-.-r Pt\ 1/ Q'
/S49Cj Of"')f.'=>A- 'T(7~IL- S(..
(Address)
Date Rec' d
,1,1,...0'/
/-04-fF'
ZONING (office use)
tel SCJ
PID 25. 048 - oz,+,o
(Phone) q5"z.- 4'-}i-SSt/<j
--- .........
'QBUILDE~) r r-
(1 ~'dUle) 1,- L."'::> -t" (L \ rc..Cb<6S L-f)JJ S-r.
(Contact Name) \L~0 rUF.;;.f)b~~
(Address)
(Phone)
(Phone)
\6020 Ss"I ~CLt\\,I('A~ LtO Pn..\O~ ~IL.~~
fl.:> "5'531 L..
TYPE OF WORK
o Misc.
o New Construction
-
~Re-ROOfing
OAlteration
~ 5"1.. - 44'1 - I ra~?-
L., \ "l. '5~"O - S SSe,
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
enter upon the property to peiiuu.. needed inspections.
X Y.JA- 'i- ~;~
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
o Deck
o Porch
OLower Level Finish
o Fireplace
OAddition
PROJECT COST /V ALUE (excluding land) $
Contractor's License No.
Z, .::> v tJ r crv
$ 7e.1.7r
$
$ /. Z.r
$
$
$
$
$
I Park Support Fee
I SAC
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
ation Becomes Your Building Permit When Approved
C;-.t,1-.ol
I Paid
I Date
7~ .()iJ
.,s-. Zz,.... 0 I
~
Date
5" - z.,2..- 6\_
I(cite .J
---------
# $
# $
$
$
# $
# $
$
$
$ 7~.0 0
~7V
Reeei . o./39t z-./
By Y()'-' .
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
ijz ~ /0/ .A",
{JI11CG,4 lie,
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/ 5 L(,?, ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: rCe - r2nrI .
DATE TIME
11/ - ~ff
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
D
/'..,..,....,. .,,--' .'"~~".~
( /(~ -~ )
"-""...."',,,... .,:.
L
)(" WORK SATISFACTORY, PROCEED
(0\ CORRECT ACTION AND PROCEED
:,::ECT ~L ~OR REINS:::,::::FORE COVE~NG
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
conE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
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