HomeMy WebLinkAboutBldg Permit 01-0988
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 si~ at bottom)
ADDRES~ 1 3 }..I 1/ / {
~ r j-tJq 5au,. Sf
LEGAL DESCRIPTION (office use only)
~E
Date Rec' d
9- (-0/
LOT BLOCK ADDITION PID
OWNER (!~rd ( [30 (fz- VL(7-5tJ~~
(Name) (Phone)
-
(Address) '--(])/ PI't"a )' QI4 f ~r 1c!' /?L. ~S-J7 2-
-
BUILDER ~ .)... lan/ho,.~ r 'ILI)- 29 yo
(Name) ~ '7 (Phone)
f f{ ~cL/ t'~ I ,
(Contact Name) (Phone)
(Address) Lf3c{~ f}&4 k(//~ ?T S~
TYPE OF WORK o New Construction ODeck o Porch ~oofing ORe-Siding
OLower Level Finish o Fireplace OAddition OAlteration OUtility Connection
o Misc.
PROJECf COST IV ALUE (excluding land) $
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 aw:~t the ilding official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;teruponthif1.evpy~ne di~. ~ h(f q~!!~() I
f 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
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
2/500.00
$ 74.7<)
$ ----
$ /.2-~
$
$
$
$
$
~il~BuilAmgp=itWhrn~d
Building Official Date
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid
I Date
rJ(~. (Jlj
r 9 "I/-d I
# $
# $
$
$
# $
# $
$
$
$ 1~ -0 0
A. -
~!ft-m~o
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
INSPE~110N NOTICE
ADDRESS
L8;), J
OWNER
PHONE NO.
o FOOTING
o FOUNDA TIO
o FRAMING
o INSULA TIO
....;;rr'1 NAL
o SITE INSP CT
COMMEN
DATE
SCHEDULED ~-;l~1'
-p~~
TIME ___
It-I"
CONTR.
PERMIT NO.
I-9gB'
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING AL
o MECH FINA
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
-
~
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~ALL 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 & SAFETYl
INSNOTI