HomeMy WebLinkAboutBldg Permit 01-0979
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yellow Applicant
Date Rec' d
14' 14'0/
"
I PERMIT NO. 01- 0'11'1 ~
(Please type or print and sign at bottom)
ADDRESS
j7l~:1 OC'5"St?A/dM'
LEGAL DESCRIPTION (office use only)
LOT I L/BLOCK ,}- ADDITION ;!vf//ffIM u~l6
ZONING (office use)
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X~ bPID25-/fJ1- 62.8"'0
OWNER
(Name)
(Address)
~ /?~
~J t/ds..rqAlA~
(Phone)
'7:~-;2 - ~~1- / s/f.J
BUILDER . . "/ J
(Name) ~,,4,5 Bt1UP'~
(Contact Name) ./ oA.4/ L I /?1f1Af'
(Address) /~11 tt/~/d~ ~ <
(Phone)
(Phone)
M~M///~/W YP;."
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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 y<vp.:.<~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
enter up~rop? to perform ~d~nspections.
X ~" 'X' J 4~ " c7tXJ &/(s-q '7
/ Signaty{e
( I
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
Plumbing Permit Fee
Mechanical Permit Fee
TYPE OF WORK
/
~e-Roofing
o New Construction
o Deck
o Porch
OLower Level Finish
o Fireplace OAddition OAlteration
PROJECT COST IV ALUE (excluding land) $ I. 7 'i d- ,
o Misc.
Contractor's License No.
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
Water Tower Fee
#
#
?~. '7C'
#
---
I.zr-
#
Builder's Deposit
lather
I TOTAL DUE
ORe-Siding
OUtility Connection
iUI
~I
$
$
$
$
$
$
$
$
$ ?~-()O
This Application Becomes Your Building Permit When Approved
I Paid
I Date
7t,.{/7/
t.7 ... -;, ~ I
" .
ReCeij(j,~~A-/
BVr- '
Building Official
Date
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
SCHEDULED ~ Lf, '1)0
(' ~A(J-
CITY OF PRIO, LAKE
INSPECTION NOTICE
ADDRESS
S'IR3
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION &J 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
~FINAL 0 PLUMBING FINAL
tJ - SITE INSPECTION 0 MECH FINAL
COMMENTS: e. ~~
~
7(; ~t:
tJ/ - 9 79
,
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
'M1 WORK SATISFACTORY, PROCEED
b CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI