HomeMy WebLinkAboutBldg Permit 01-0890
(Please type or print and sign at bottom)
ADDRESS
/4-320
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
LO/~ A-Y6
LEGAL DESCRIPTION (office use only)
LOT fR BLOCK
OWNER
(Name)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
ADDITION
o New Construction
OLower Level Finish
(,
.;
o 1-['lD
I PERMIT NO.
I. White File
2. Pink City
3. Yellow Applicant
#6
PID 25-122-- OO~- 0
(Phone)
11- LI-'"? _ ;3 ,,-2 ,6
(Phone)
(Phone)
o Deck
~Re-ROOfing
OAlteration
o Porch
o Fireplace
OAddition
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
;te~57~ns. ~ ;l. () -~OP/
Signature / - Contractor's License No. - 7 Date
2,500.00
'14-. 7~
15()(/o//Vs n/lN()~
3 p(;I ,4t)PN.
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- t./
Itf3') 0 t&7/ ~ ~ t/-P jt/ E
I Permit Valuation
I Permit Fee
I 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
PROJECT COST IV ALUE (excluding land) $
$
$
$
$
$
$
$
$
/. ~5
Th;, "")1';!;,r Yo", BWldffig P""," Whom_
'/d/lfj- t3 .? 1).0 /
Building Official 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
Other
#
#
#
#
$
$
$
$
$
$
$
$
$ 7~.OO
ReceMo,
BVr--
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
TOTAL DUE
I Paid
I Date
7~.OO
e-ZO,OI
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE TIME
.r< LAKE
.IN NOTICE
ADDRESS
1~3C)-O
SCHEDULED 9/~ I
~k.
At"
OWNER
CONTR.
PHONE NO.
PERMIT NO.
tJl-7J(J
o FOOTING
o FOUNDATION
o FRAMING @J
o INSULATION
'Bl FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS: ~
-
('~ ~
'tsa1 WORK SATISFACTORY, PROCEED
(0- CORRECT ACTION AND PROCEED
o CORRECT WORKOALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ I Owner/Contr:
J
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl