HomeMy WebLinkAboutBldg Permit 01-0985
(Please type or orint and sijtll at bottom)
. ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
. AND UTILITY CONNECTION PERMIT
Date Rec' d
~6/
L White File I PERMIT NO.
2. Pink City
3. Yellow Applicant
570 () pi I/a-rt tvtJ .r-t1tJle..bJ r r
LEGAL DESCRIPTION (office use only)
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BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
ADDITION
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51-1o~s'
(Phone)
T1L .
(Phone)
(Phone)
ODeck
- I
,J(Re-ROOfing
OAlteration
NING (office use)
I ,eISO
i{
PID 7Q - 031 -0/" -!
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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 roperty and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. .~:~.&iare tha e bu' - g official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
~ter upon the pr~oktifo ne.ed inspections. 7 ~
Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
o New Construction
OLower Level Finish
o Porch
o Fireplace
OAddition
PROJECT COST /V ALUE (excluding land) $
2j 500.00
$ ref. 1 ('
$
$ /.z,}-
$
$
$
$
$
T!rl. ^1l!J'~:::~ Building Pmnit Wh<n__
Building Official Date
Park Support Fee
SAC
Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE
-
Paid 7/". if V
Date . It '-If) - f1 I
;. 'L../
# $
# $
$
$
# $
# $
$
$
$ 7v'O{)
, .
Receip).tIJ..# <""'~ 1
Bv 71-
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
INSPECTION NOTICE SCHEDULED 9-11'0 I A. r.
ADDRESS 571FD PJ:1/~WN $fItJ,e&s
OWNER
CONTR.
PHONE NO.
PERMIT NO.
/-'185
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
\P( FINAL
~ 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:
/U'bF
-
Lf~~
po WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
~I
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.:.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI