HomeMy WebLinkAboutBldg Permit 01-0941
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
'AND UTILITY CONNECTION PERMIT
(Please type or print and si~ at bottom)
ADDRESS
16I)~ //J~a
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1. White File
2. Pink City
3 . Yellow Applicant
LEGAL DESCR1.t'TlON (office use only)
LOT 7 BLOCK q ADDITION (l ~ -:rf,dC?.e--
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OWNER
(Name)
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(Address)
BUILDER Au .. / L
(Name) /f/!(}.#S LfJIII /or{l k <
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(Contact Name)
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(Address)
TYPE OF WORK
o New Construction
OLower Level Finish
o Misc.
(Phone)
Date Rec' d
PERMIT NO.O 1- 1 L/ J
ZONING (office use)
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PID ~3,1~'" 03t-Q
tj' ~ J - q4l<::7 -ltf 1,-(
(Phone) '!Cf7 - Lf()65
(Phone) ~ ./.2. ..f6 7 '- a~ J
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o Porch ~e-Roofing ORe-Siding
ODeck
PROJECT COST IV ALUE (excluding land) $
o Fireplace
OAddition
OAIteration
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. m aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter upon rop rty to erform needed inspections.
;X. ~
Signature /
I
x
I
l
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
.-"
-Ii{, /J
$
$~
$
$
$
$
$
$
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This Application Becomes Your Building Permit When Approved
Building Official
Date
c:1-tJ.d 6' ~)" f 7
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 TOTAL DUE
I Paid;17~ ,,00
I Date 8'" (1c;-o/
OUtility Connection
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f Dafe
#
#
$
$
$
$
$
$
$
$
$
#
#
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Receipt No. LID ~ ik
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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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED,
DATE TIME
~/YI/(JI A,I I
, ,
ADDRESS
/ Cd 3 53
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OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING ~
o INSULATION
FINAL
~ SITE INSPECT
COMMENTS:
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'..,
-.....
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER OKUP
o PLUM FINAL
o MECK ;6.L
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
l WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WOE.' CALL FOR REINSPECTION BEFORE COVERING
Inspector: WI Owner/Contr:
CALL 447-98sJFOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI