HomeMy WebLinkAboutBldg Permit 01-0622
(Please type or print and siJn1 at bottom)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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I. White File
2. Pink City
3. Ye\low Applicant
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LEGAL DESCRIPTION (office use only)
LOT 8BLOCK b ADDITION S()I\/Sl57 H/US rJ-OlJN.
K~r(
OWNER
(Name)
(Address)~S~ 0 (
.~ J f}1
5 yPlU r-€'
I
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
IrA.' ( S. JJ
o New Construction
OLower Level Finish
Date Rec' d
PID 25-/72-- 081, CL
frlor
(Phone) 1)" d2 - if L{ 7 - I 7 7 &='
t./v! ( JVI rJ . 5 s:g 7;)..
(Phone)
(Phone)
ODeck
~-Roofin'
OAlteration
OPorch
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
enter upon ~roperty to perform neejed inspecti~~s.
X L'lL-Lu~cK.. ~ (;,_;</-01
Signature Contractor's License No. Date
I Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
PROJECT COST IV ALUE (excluding land) $
'2t 57JV ~ (j?)
$ r ~4-,r ?S-
$ ~ /. z..- c)
$
$
$
$
$
$
es Your Building Permit When Approved
~.Ol
Date
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
I WaterTowerFee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid
I Date
-
'lc,.OO
10 · '14' t) 1
# $
# $
$
$
# $
# $
$
$
$ 71d" 00
,
Recf'1-e'p . .3"-"0
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
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sf{~ ~
CONTR,
CITY OF PRIOR LAKE
INSPECTION No.TICE
SCHEDULED
ADDRESS
'3 d-.O ,
OWNER
TIME
$~30
PHONE NO.
PERMIT NO. 0 I -O~ :2~ .
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
[]~ULA TION 0 SEWER HOOKUP
~ ~~~AL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
('
COMMENTS: 18,.,- \to(; \
"
~de
/? /5>~e
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
0'
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~', CALL FOR REINSPECTION BEFORE COVERING
Inspecto$... VcPJJ..b Owner/Contr:
CALL 447.9850 FOR' .HE NEXT INSPECTION 24 HOURS IN ADVANCE,
l .
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl