HomeMy WebLinkAboutBldg Permit 01-0777
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
.-q--o re_sf
~+
55'10
LEGAL DESCRIPTION (office use only)
LOT I BLOCK I ADDITION
OWNER
(Name)
J/~
(Address)
;::: cYlkJ+-(i} fJ L
/~-
(Phone)
Date Rec'd
PERMIT NOOI-01771
ZONING (office use)
~/SD
7/b1- 00(-0
PIDJS"- ~-()5I-C'
r
BUILDER f) J 1.1./1 o.A 0 U.-J /J1fl //"11 /
(Name) (Y l\~fL' ^..~ -0-- r~3- (Phone) ~
(Contact Name) -eu/-t- !0 'I:'.~ (Phone) ~! ~ ~ 5 '1- IS- 5"' '1
(Address) >(;)-G;/ K/Vl;(P,LOad ~~~ U).a{J-f !;c;//;}--' ,
TYPE OF WORK
DMisc.
o New Construction
o Deck
DPorch
..Brre- 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 all construction will conform to all existing state and local laws and will proceed in accordance with
submitted Plan~~ aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;ter upon ~4d.Jerf~ns. ______ 62/!J / -; q I tJ I $Y' /~ I
. - ~aft1re ~ ~ Conttactor's License No. /--- Date
~~
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
OLower Level Finish
o Fireplace
OAddition
OAlteration
PROJECT COST /V ALUE (excluding land) $
~
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTALDUE
L1 .
I pai#1 "7 b rOU
I Date -;., :::l. q - (J I
/
$
$
$
$
$
$
$
$
->>75'
/ "C)-5'
This Application Becomes Your Building Permit When Approved
Building Official
Date
# $
# $
$
$
# $
# $
$
$
$ 76 ~OV
.r'/'
Receipt No. L.I' U I (6 (}
By ar /'
(J
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
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
7. 2..fe, '0 /
A_T.
ADDRESS
559() FtJ.eEST e-I .
OWNER
CONTR.
PHONE NO.
PERMIT NO.
() I - 077 7
o FOOTING 0 PLUMBING RI
o FOUNDATION:tfB)D MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
FINAL I!:.bO 0 PLUMBING FINAL
~ SITE INSPEC 10 0 MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
.... ~ . ~
,~-
(I/~
~.
"~ .._~
.~
'ij WORK SATISFACTORY, PROCEED
,b CORRECT ACTION AND PROCEED
o CORRECT W~LL FOR REINSPECTION BEFORE COVERING
Inspector: - ~ Owner/Contr:
f
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl