HomeMy WebLinkAboutBldg Permit 01-0787
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
7 _",,(r- d /
\J;.~lease type or Print and si~ at bu"um)
J~DDRESS ZONING (office use)
I 1~4-00 ,qun()~ AV~
I. White File I PERMIT NO
2. Pink City . 0 I". 0 1 f)' 1
3. Yellow Applicant 6
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
t\\...~ \f \ I
(~~ ck
\( ,e <, ,,-e'<'
~ \ \\ ~\~ ~'\R. <;~
C~"'~\ .
(Phone) ~ S L - LJ4, - ~ 114
(Address)
'{BUILDER \ \ \" \
(Name) \-..p~\ ~jQ
(Contact Name) \<:\"-' '"
(Address) (n~~ ~. \-L~l
\~I'.
(Phone)
(Phone)
<is I '-4LtS~ LA~~
~
6 \<...- I ~t1 "'{~6
s~
S,- \t it U <t
tv\v
c:;s ~l<t
TYPE OF WORK
o New Construction
ODeck
OPorch
OAddition
~e-ROOfing
OAlteration
ORe-Siding
OLower Level Finish
o Fireplace
OUtility Connection
o Misc.
PROJECT COST IV ALUE (excluding land) $
Si2> \S.~
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-~m' oned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. ~m e th e\building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;ter upon the pr erfo;~ns. b<b b "3 1-1.$-0 \
/SIgnature ) Contractor's License No. mate )
l '----- ~\--=
I Permit Valuation "?, nrv ~ f1lJ I Park Support Fee # $
I Permit Fee $ 1 c.f. '7 r I SAC # $
!PlanCheckFee $ IWaterMeter Size 5/8"; 1"; $
I State Surcharge $ I. rV I Pressure Reducer $
I Penalty $ I Sewer/Water Connection Fee # $
I Plumbing Permit Fee $ I Water Tower Fee # $
I Mechanical Permit Fee $ I Builder's Deposit $
I Sewer & Water Permit Fee $ I Other $
I Gas Fireplace Permit Fee $ I TOTAL DUE $ 7 (,. r7J
ThisA(f2fJfl-PliCatiO Beco esYourBuildingPermitWhenApproved I Paid 7~ ~(/U Rece~'Pt . I f-{(J' /cJ
I Date ? r 2J -01 By /j ,.,.
77-S-~dl
Building Official Date
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
/to'-{oo
OWNER
PHONE NO.
DATE TIME
SCHEDULED ~O(
i-~
CONTR.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATIO@ 0 MECHRI
o FRAMING . ,..<.; 0 WATER HOOKUP
o INSULATION F , 0 SEWER HOOKUP
tt FINAL 0 PLUMBING FINAL
o SITE INSPEC I 0 MECH FINAL
COMMENTS: 120-0-1 ,
tl..-.
r5~
~-
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/ )
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CJI - 7i"7
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~ORK SATISFACTORY, PROCEED
,{:~'ORRECT ACTION AND PROCEED
o CORRECT WORLAL~ FOR REINSPECTION BEFORE COVERING
Inspector: VJ;:y' Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI