HomeMy WebLinkAboutBldg Permit 01-0917
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and si~ at bottom)
ADDRESS
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LEGA~ 1;)ESCRit'TlON (office use only)
fJr (5).. ~ cJ- 4 B L '3
LOT BL(()CK ADDITION
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I. White File
2. Pink City
3 . Yellow Applicant
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OWNER
(Name)
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~o e.Se-.
(Address)
BUILDER l-~ I .... I r t
(Name) ,~t'/I ilOfJ r'- (_ 4^JC, r-
(Contact Name) {) ~ F:h Ie r5
(Address)
TYPE OF WORK
o New Construction
OLower Level Finish
o Misc.
(Phone)
~d
,.,;
(Phone)
(Phone) /.p) /- LJfa 3-4 DL\ b
o Deck
>>e-ROOfing
, dAlteration
o Porch
o Fireplace
OAddition
PROJECT COST IV ALUE (excluding land) $
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
;~~~~.om .)...C'/ ~ </ llYV r-h71,/
Signature Contractor's License No. / Iifate
Permit Valuation
Permit Fee $ 7l/;o /~
Plan Check Fee $
State Surcharge $ 1- (3..)
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Permit When Approved
Building Official
Date
Park Support Fee
SAC
#
#
$
$
$
$
$
$
$
$
$ 7{ro ,{jU
Receipt No.lIOS -03
By r"
U
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
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
#
#
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
I Paid
I Date
-J" . 0 0 .
~--d-~-U ,
I
DATE
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
4641
ADDRESS - PLEASANT
OWNER 01-0917
- Re-Roof
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
W . "'_h__
] EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
CLOSE FILE
19\i~~ F~ I ~r'::>Urt, DuilJing :LnspecTor
DEe 2 2003
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNon
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