HomeMy WebLinkAboutBldg Permit 01-0925
(Please type or print and sign at bottom)
. ADDRESS J L-/I L/ 2
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White File
2. Pink City
3. Yellow Applicant
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LEGAL DESCRIPTION (office use only)
LOT3 BLOCK a ADDITION<-f)
OWNER
(Name)
J t"1"V' 7'
, I
/4 ( C{ 2.
(Address)
At) (/I So 0
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fJE
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BUILDER;' L 4-
(Name) a " ~ VI 0 rv-{
V
(Contact Name)
(Address) L(3'-t'S'"'
(Phone)
(Phone)
tM-kcJ 1#1- ~ r 5E
TYPE OF WORK
Date Rec' d
-9d-5' I
LlLf 7r 21 ~
ODeck
o Porch
OAddition
.e-Roofing
OAlteration
3r=l- PID d5" - 07J/ -oo8::()
(Phone) '-!1~ ..../q 5'0
o New Construction
o Fireplace
o Misc.
OLower Level Finish
PROJECT COST IV ALUE (excluding land) $
I hereby certify that I have fu
authorized agent for the ab e-m
sUbmitt;:n~1 I am e
~ter u~operty perf,
V - 1/ Signature
"
ORe-Siding
OUtiIity Connection
information on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or
Cl property and that all construction will conform to all existing state and local laws and will proceed in accordance with
building official can revoke this permit for just cause. Furtherptore, I hereby agree that the city official or a designee may
. ections. O~ Tt I Co( ?; ...::27- 6/
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
Contractor's License No.
$
$
$
$
$
$
$
$
Park Support Fee
SAC
7'1, 7~
/~ d-es-
Water Meter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid
I Date
7~ .()O
9;- d.'-o,
This Application Becomes Your Building Permit When Approved
Building Official
Date
#
#
#
#
Date
$
$
$
$
$
$
$
$
$ ?~rCY
, .-
ReceiptNo.l/O ~ '1:J-
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
IN~PECTION NOTICE
SCHEDULED
9~(, ,01
11.1:
ADDRESS
/4/4-~ /}SH e--IL.
OWNER
CONTR,
PHONE NO.
PERMIT NO.
I - ejz.- c;-
o FOOTING
o FOUNDATION ~
o FRAMING
o INSULATION
FINAL /t:.-tJOr
~ 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:
~.~
'j( WORK SATISFACTORY, PROCEED
b CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
~(
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Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI