HomeMy WebLinkAboutBldg Permit 01-0782
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
7,ZS'O/
I PERMIT NOo()/ -0 '1 f!,~2-
,
ZONING (office use)
(Please type or print and siM at bottom)
ADDRESS
54/4- 8()vtV1f
SI s 6"
LEGAL DESCRIPTION (office use only)
LOT IOBLOCK 3 ADDITION 1JK-tJ()~t//~ ff/(,~J "17t-
OWNER
(Name)
(Address)
(Phone)
PID 2-5'/ f?; 7 - ClSf-O
BUILDER t I )
(Name) /'//1. J<e/lABc1~ J: vV C. (Phone). S'Z.Jl./c.J7- 3t.J7'1'
(Contact N~me) ~ e. A/Lo. reJ.AJ OJ (Phone) &?/2 l!fJ6- 2.b '-If'')
-
(Address) /51-11 fq.JrbvJK~1ifJJl AIL !Jr,o/'LQk,,e ,A1.,-^1 ;43/,---,
TYPE OF WORK
o Misc.
o New Construction
,
~Re-ROOfing
OAlteration
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 lans. 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
ente nthe ope~tope::;~ 1/2G/6/
Signature { / Contractor's License No. Date
Permit Valuation
Permit Fee
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
o Deck
OPorch
OLower Level Finish
o Fireplace
OAddition
PROJECT COST /V ALUE (excluding land) $
2~ ~ AlV
$ . 7c/. 1 r
$
$ I. 1." r
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
7(, OV
~_ ?~r_
.
Building Official
Date
#
#
#
#
6 I
$
$
$
$
$
$
$
$
$
7b. Q'7/
ReceiRID o. 40 /11
By IfJlIA~
/
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
5L(L~
OWNER
PHONE NO.
DATE TIME
SCHEDULED D~ .A-LD
.~J:;'I
CONTR.
PERMIT NO.
o ( - A?z.,.
o FOOTING
o FOUNDATION$)
o FRAMING
o INSULATION
~ FINAL
rO SITE INSPECTION
COMMENTS: ~
( (,(~~2e~)
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
)4WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~
- - J .
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
Inspector:
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI