HomeMy WebLinkAboutBldg Permit 01-0634
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date' Rec' d
1. White File
2. Pink City
3. Yellow Applicant
(Please type or print and sign at bottom)
. ADDRESS
blA~ -:f?~rl.k
LEGAL DESCRIPTION (office use only) . ~ rl- t't-
~ -'"1. ~G~ +-s,\ft F- S-
LOT BtOCK ADDITION
OWNER
(Name)
W,'ll W~\,VI ~~
\ bt.'~ ~ (f\(<,.../
(Phone)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
(Phone)
(Phone)
o New Construction
DDeck
o Porch
~e-ROOfing
OAlteration
NING (office use)
'~/SD
PIDd5 -/R-1- t/:l.).-O
4tf7
c, c;:Y I
OLower Level Finish
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 uil' official can revoke this permit for just cause. Furthermore, I hereby agree that the city official ~r a signee may
;ter upo~erfO ded' spections. /' ~ ~(1 L
L ,. S gn r Contractor's License No. (!jL.~at
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
I Gas Fireplace Permit Fee
o Fireplace
PROJECT COST IV ALUE (excluding land) $
$ 7'-1. /~
$
$ 1';)'5
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I WaterTowerFee
I Builder's Deposit
I Other
I TOTAL DUE
This Application Becomes Your Building Permit When Approved
I Paid
I Date
.. ...
IV'OU
/~/d510 I
I ( .
Building Official
Date
#
#
#
#
$
$
$
$
$
$
$
$
$ 'I/o.C/D
Receipt No..i'f s(5 h
By r~
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
.........,.....+. .........,. m.
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
ADDRESS
li, 439
SCHEDULED ~/2/,/O(
&Lk,
A.Tt
OWNER
CONTR.
PHONE NO.
PERMIT NO.
LJ I - ~'-I
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULA TJGffI 0 SEWER HOOKUP 0 FIREPLACE FINAL
;g FINAL (!'k / 0 PLUMBING FINAL 0 GASLlNE AIR TST
o SITE IN~....:,- TION 0 MECH FIN~ 0
COMMENTS: ~ 1-Its'S6S
/J I
/) / /J(r' - r II ~(
L/U/}..-/ r f -
IWORKSATISFACTORY, PROCEED
o CORRECT ACTION "'1PROCEED
o CORRECT WOfJ'. C'~ :?R REINSPECTION BEFORE COVERING
Inspector: r--: \ ' Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
. ... . .. ..1.--................ .