HomeMy WebLinkAboutBldg Permit 01-0940
CITY OF PRIOR LAKE BUILDING PERMIT,
TEM.pORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White File
2. Pink City
3 . Yellow Applicant
Date Rec' d
PERMIT NOO/-CjLjCJ
(Please type or print and sign at bottom)
ADDRESS
/'/S7;:J ~k
~/.~E
LEGAL DESCRIPTION (office use only)
LOT t( BLOCK d- ADDITION ({)~)
OWNER
(Name)
~ 4- h~.J
/9'~7-'
(Address)
BUILDER
(N ame)
(Contact Name)
(Address)
~
PID;)5-/3gr O/f-{)
R~L:
A1J/14 /~/ S.c.
~ptl #KA::S
/htl.d<
(Phone)
,/tIt/J#s
d;.6v
/d.;? S/ a/~ah
TYPE OF WORK
o Misc.
ZONING (office use)
RJsD
LlL/?-79/Al
, .
(Phone)
(Phone)
./IJ IJ
r} ~ 4-'/7 L/c;(S
(/.;1.- Sh 7..- C;~s:27
~"
&.-("'A/S'".#/4
. -/
/'
~e-Roofing
OAlteration
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
~ter upczz: 1'~form nee d i spections. of CJ-O 6'/ r r"7 ~ ) ;If jy J
/ Si Contractor's License No. I Die
{
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
o New Construction
DDeck
o Porch
OAddition
OLower Level Finish
o Fireplace
PROJECTCOST/VALUE (excluding land) $ 77Y r (lal
,
$
$
$
$
$
$
$
$
jtf;,S
I Park Support Fee
I SAC
Water Meter Size 5/8"; 1";
#
#
J,a~
Pressure Reducer
Sewer/Water Connection Fee
#
I Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE
#
This Application Becomes Your Building Permit When Approved
I Paid f.'16'~
I Date CC,. ;tq -0 J
Building Official
Date
$
$
$
$
$
$
$
$
$
7 ~ ,m
Receipt No. 4() .~ I b
By ~/
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
CITY OF PRIOR LAKE q k-/
INSPECTION NOTICE ~ SCHEDULED ~~I
ADDRESS I L( S? 2-- ~ (R-,
,
TIME
AL(-.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
tJ/- 9 ~(j
o FOOTING
o FOUNDATION m
o FRAMING
o INSULATION
~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 GASLINE AIR TST
o
COMMENTS: &. -~oF,
(?v~
r
--~
~ WORK SATISFACTORY, PROCEED
/; CORRECT ACTION AND PROCEED
o CORRECT WOR~LL FOR REINSPECTION BEFORE COVERING
/.
Inspector: . Owner/Contr:
J
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl