HomeMy WebLinkAboutBldg Permit 01-0644
(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
Date Rec' d
(,-2-8"'0/
PERMIT NO. O/-O(g~
~267J Q(/;::;K-~ '/t<!A- NC
LEGAL DESCRIPTION (office use only)
LOT~OCK
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(~)CA~d
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
ADDITION ,,-I?/9-?'~ /'.J:::=. f #tJ/Z..6...r
PID 2.5 -~30 - tJ:~9- 0
/J;/edIr~/&
(Phone)
ZONING (office use)
E../..s;C)
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 perform needed inspections.
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I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
(Phone)
(Phone)
o New Construction
ODeck
,
)aRe-ROOfing
OAlteration
OLower Level Finish
o Fireplace
OPorch
OAddition
PROJECT COST IV ALUE (excluding land) S
Contractor's License No.
$
$
$
$
$
$
$
$
Vr7rV
"1t{.7>"
---
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Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
#
#
Park Support Fee
SAC
#
#
Water Meter
Size 5/8"; I";
Th'?"WJ ~comes Your Building Permit When Approved
U//I/h- -- 19' U~~ I
Building Official Date
-
I Paid 'Z fL . q fI
I Date f - ,-{ ..I f
,hn/ 2B (9)
DateJ
$
$
$
$
$
$
$
$
-
$ 1'. dll
R.ec~rK..o, .39 1;10 ~
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
(j :;)-~ ()
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
~NSULATION
"', FINAL
., . 0 SITE INSPECTION
DATE TIME
&\,;HEQULED 7-/6ro I
~t@~~/U
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o ~ECH FINAL
(DOCl ~-
, '
COMMENTS:
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7 -to lIY'
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/"
~ORK SATISFACTORY, PROCEED
o CORRECT ACTI N AND PROCEED
D CO~.f;' . CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL 447-9850 FO THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
'"r- .._. ....
INSNOTI