HomeMy WebLinkAboutBldg Permit 01-0938
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
/7~Gq Stl#S'I5T (,G,t9/0
LEGAL DESCRLt'uON (office use only)
LOT23BLOCK / ADDITION fVOOOV/~ I sr
OWNER
(Name)
TS { rt c'l'\L tT-1'l G5
S~-t
(Address)
BUILDER
(Name~
(Contact Name)
(Address)
~fulr<.
r;-~+-
17CO 15~
TYPE OF WORK
o Misc.
rt=dJ'\r ~/P 'V
/1,/.
o New Construction
OLower Level Finish
(Phone)
Date Rec' d
f-2-9~1
PID Z.cs- - Irs. (52-3'-0
f'5 ). - ;;l;J..0 - 5" 7/6
(Phone) 7GJ- 5'1I-o~N
(Phone)
ODeck
J
~e-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 p,vl'<"~f 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
;ter upon the property to perf; 5P inspections. ?O /5 5~00 e/~r /at
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 /V ALUE (excluding land) $
Signature
'Z-/ 5"" o-t). (JV
$ 7cf.?r-
$
$ /. Z r
$
$
$
$
$
no;, 7ti7iJ"=. Y= BuiIiling P<=itWbro_d
SI,Zfj.-(/ /
, Building Official Date
Contractor's License No.
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 TOTALDUE
I Paid
I Date
7ft:;. 0 V
- r-2./I-p /
Date
# $
# $
$
$
# $
# $
$
$
$ ?t.OO
Recef ~/4--
By A
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
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED
ADDRESS /?~b9 So;uel-
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
COMMENTS:
# /J
/-eytXJ r
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
// '? /-
(.~~p/ /~ I~
,
DATE TIME
~k)-
, ~
0/ - ;? S' %"
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE R1
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~--~~
/' .-;/ ---f ')
( /'_/eue- .h I~ ~
~~II~FACTOft r. t"t<u~ED ------
o CORRECT ACTION AND PROCEED
o CORRECT WOR~. r;:L;, ~ REINSPECTION BEFORE COVERING
Inspector: j/'~ Owner/Contr:
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETY!
INSNOTI