HomeMy WebLinkAboutBldg Permit 01-0922
(Please type or print and sign at bottom)
ADDRESS
I t /J.. S- .;{
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yellow Applicant
Pt2/J{LJle0 D v-'
LEGAL DESCRIPTION (office use only)
LOT ,~BLOCK .~~ ADDITIONd/~tlfJ
Na rriSO,)
OWNER--r-:~
(Name) / / m
(Address)
BUILDER (1 ^ ~ _. ^ ./
(Name) C'\:) { .l/Y~
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
o New Construction
OLower Level Finish
Da.
NING (office use)
(JttD
;:?, c~~ PID;;;l.)- d.-qq-03Lt9
(PhOne)"tJ t~J '137 09'0
(Phone)
(Phone)
ODeck
OPorch
ORe-Roofing
OAlteration
PROJECT COST/VALUE (excluding land) $
o Fireplace
OAddition
~e-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
en~?pe, 7erform needed inspe~ons.
X 7~A7~~/7\.)(-;<Y-ol
{ - . I' · Signature - Contractor's License No. Date
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
$
$
$
$
$
$
$
$
;L/- 7S-
/1 ;;X3
This Application Becomes Your Building Permit When Approved
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
I Other
I TOTAL DUE
I Paid $ 7C,--W
I Date (/~ ::::J-t/- 0/
,
# $
# $
$
$
# $
# $
$
$
$ 7/0 ,d)
-
Receipt No. Lit) -6'1 d--
By r
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
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
PHONE NO.
16252
P ARKVIEW
01-0922
Re-Side
ADDRESS
OWNER
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
U PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
CLOSE-FILE
19\ik~ reterson, Suilding InspeCTor
5EC 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 &: SAFETY!
INSNOTI