HomeMy WebLinkAboutBldg Permit 01-0639
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
, AND UTILITY CONNECTION PERMIT
(Please type or print and siltll at bottom)
ADDRESS
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2. Pink City
3, Yellow Applicant
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LEGAL DESCRIPTION (office use only)
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OWNER /)
(Name) --1...!//} 1/ ee10
(Address)
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BUILDER ~ l_
(Name)-+-0J lI/U ,-U./.MJt?J1.<J
(Contact Name)
(Address)
TYPE OF WORK.
o Misc.
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o New Construction
ODeck
NING (office use)
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(Phone) tiS;>. :-qqO- s:'6Q7
(Phone)
(Phone)
o Porch
~Roofing
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 aU construction will conform to all existing state and local laws and will proceed in accordance with
submi d 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
e pm the pror m;eeded inspections. .;)...0 / ~ S- 0 ,5' 6 Io-~ -() J
Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
Penalty
Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
OLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
OAddition
OAIteration
$
$
$
$
$
$
$
$
7Lf- 7-:Y
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This Application Becomes Your Building Permit When Approved
Building Official
Date
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid
I Date
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(L? / 'd-- t.o IOJ
! /
#
#
#
#
I $
$
$
$
$
$
$
$
$
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Receipt N OJ-- ~ Qff5"'6
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
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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
ADDRESS
16227
- IT ASCA
01-0639
Re-Roof
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
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
o GAS LINE AIR TST
o
COMMENTS:
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Mike Peterson, Building Inspector
DEe 2 ZUU3
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYl
INSNOTI
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