HomeMy WebLinkAboutBldg Permit 01-0840
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(Please type or print and sign at bottom)
ADDRESS
L White File
2. Pink City
3 . Yellow Applicant
ZONING (office use)
PU.C;J)
S7g?-I3~~d ~
LEGAL DESCRIPTION (office use only) /,
LOTJ BLOCK S- ADDITION~d
;P~ d~
PIDdS-- c).Or::;- O~-D
OWNER
(Name)
mwJe ()~
I
(Phone)
(Address)
BUILDER /j J!~,.p, /'A A /J~'IJ __A .; J. ,
(Name) ( /Afl) y '-' ~ !LT'~
(Contact Name) ~ U8t/!Li./ ~_ ,
(Address)
(Phone)
---
(PhoneV;/ ;;"-3d-%-h /;;"!J
TYPE OF WORK
o New Construction
ODeck
OPorch
~e-Roofing
ORe-Siding
OLower Level Finish
o Fireplace
OAddition
OAlteration
OUtility Connection
o Misc.
PROJECT COST/VALUE (excluding land) $
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 enti~ned operty d that all construction will conform,to all existing state and local laws and will proceed in accordance with
submitted ns. I am aware that the b' g offi at can revo this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;ter upon the operty ::orm nee nspe' ns. ;::; O.:l r;, ~ 9 oL-j ~ - I, _ 0 f
Signatyt'('/ Contractor's License No. Date
/' /7
Permi~tion / / I Park Support Fee # $
Permit Fee v $ -J'I- -J 5 I SAC # $
Plan Check Fee $ I Water Meter Size 5/8"; I"; $
State Surcharge $ / ' C).-5 I Pressure Reducer $
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 $ IJ ~ ,()()
This Application Becomes Your Building Permit When Approved
I Paid
I Date
7~ rUO
~-f.e, -0 I
Receipt No. LlQ 3~' 1
By Ci.0
U
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 ~~J(~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.P-fINAL
o SITE INSPECTION
COMMENTS:
DATE TIME
SCHEDULED ;I~~~~
~}-cA~aod
,>r
CONTR.
PERMIT NO.
CJ/-cr~cJ
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
./ ()
~ e /00 r
// / /
(O~P' /~ re
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: _ ~ . Owner/Contr:
r
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
lNSNon