HomeMy WebLinkAboutBldg Permit 01-0874
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yellow Applicant
Date Rec' d
PERMIT NO. ()J-:
{:i
(Please type or print and sign at bottom)
ADDRESS
/ Co 251- Pwl..vte-w /)r. <:;,~.
LEGAL DESCRIPTION (office use only)
d31o(-:~;LOCK 3 ADDITION
17n-, ~/'I'"' I 5 oYl
Ie ?>' 2. /'ev-..< Ii .0. ~ pro S, ~ ,
OWNER
(Name)
(Address)
~ f?1'c/fv
v
/sr
PID
ZONING (office use)
-::J i;- .;tlCj- () 3l1uD
A
/'
Pao
(Phone) L/f~ ->0'" C;
BUILDER f}_ d n{
(Name) (/: IUu~ (:)~ I vI;I-
(Contact Name) 'So<- ,/Vl c>f1~ D
(Address) IC;';2. "3Q ~t/"'b..~~ I..-&ul
TYPE OF WORK
o Misc.
(Phone)
(Phone)
~c" (t:rL
o New Construction
o Porch
~e-ROOfing
OAlteration
9'0-: 79'?> ~~2q
C~~-- $"qo ~2CW
05"72-
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 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 upon the property to perform needed inspections.
~ ~,,-- ~--?~
C SigtG"ture
x
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
ODeck
OLower Level Finish
OAddition
o Fireplace
PROJECTCOST/VALUE (excluding land) $
20~ ~ ?>"",77
Contractor's License No.
$
$
$
$
$
$
$
$
lit '-J '5'
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
/. rl. 5"
Builder's Deposit
I Other
I TOTAL DUE
This Application Becomes Your Building Permit When Approved
I Paid
I Date
~
,'-" .0 V
~-Ifo-o{
Building Official
Date
#
#
#
#
'lJ/t~A1/
/ mte
$
$
$
$
$
$
$
$
$
16 ,()O
Receipt No. Lff) ~~1
(jr ~. .
By
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
W ti'F~ A..,J',
~,&,
CITY OF PRIOR LA~E
INSPECTION NOTICE
SCHEDULED
ADDRESS
I &,.;l S,;;t
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING (@
o INSULATION
1JI. FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS: ~_0lIl'" __~ /
W~P>
.-.... - ....'"
DATE TIME
~/ -?7lf
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~. Il~~.~
~~ I. 'L'':tL V-
-. - --J f~- Ot -"'!;J.;J.
fJ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~ Owner/Contr:
- I'
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!