HomeMy WebLinkAboutBldg Permit 01-0869
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
1. White File
2. Pink City
3. Yellow Applicant
(Please type or orint and sign at bottom)
ADDRESS
/ b 7 9.0- llJJ l Ltu.~J
ZONING (office use)
RI
lA !y~ ~
LEGAL DESCRIPTION (office use only)
LOT '6 BLOCK ~ ADDITION
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PID ;;:S"d,l./g-O/C)-6
OWNER
(N ame) 'D yt V I D + /1J.J.Ji
(Address) Lb 7 CJ S-
lA-RSEN
1~\ILL~IJ) LN
(Phone) gSIJ- J./!f? -0977
BUILDEl}, .-L 'A.
(N ame LtlJ.J..J.J.FeJ<
C f) AI sT: III (' L- (Phone) ?\. ~-rJ - 89 JI-.. ~ II '3
DR - Ru I? Nfi V I L.J Fl..; }/I)J
f: 1l!;;J2 $D N
R..l Ve~ (J)(')ti/J
(Address) I/o if
ODeck
OPorch
o New Construction
~oofing
ORe-Siding
TYPE OF WORK
o Fireplace
OAddition OAlteration OUtility Connection
PROJECT COST/VALUE (excluding land) $ ,');7 J.t5&O
,
OLower Level Finish
o Misc.
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 u~n ~rope~perforI7eded i~ns. D k /
xfJA'~~.'lLu.4L1fI1 f?!Arr5CJ&81;/ ?-//J-oL
Signature Contractor's License No. Date
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 Permit Fee
I Plan Check Fee
I State Surcharge
Penalty
Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
j't--;tj'
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$ 7fc.oO
) ,. d5
This Application Becomes Your Building Permit When Approved
TOTAL DUE
Paid 16.0)
Date .~ - I C;-O ,
Receipt No. L/(j~
By ~ '
Date
Building Official
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.
Date Special Conditions, ifany
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Planning Director
CITY OF PRIOR LAKE
INSPECTION 'NOTICE
SCHEDULE Dr g i2-o~~_
/h79:S- (j~bJ ~
ADDRESS
OWNER
CONTR.
/-907
t-
o FOOTING 0 PLUMBING RI 0 EX/GRAD/FILLING
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULATION 0 SEWER HOOKUP 0 FIREPLACE FINAL
EJ FINAL 0 PLUMBING FINAL 0 GASLlNE AIR TST
(0' SITE INSPECTION ",0 M:r; :NA.lL~ 0
COMMENTS: ,---=:J~~
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~ ,-v? -<l.t'~L ryJ) ~ I~
n~ _ _
PHONE NO.
PERMIT NO.
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'tikORK SATISFACTORY, PROCEED
to -CORRECT ACTION AND PROCEED
o CORRECT WORK~'FOR REINSPECTlON BEFORE COVERING
Inspector: t Owner/Contr:
CALL 447-9850 FOR........ E NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI