HomeMy WebLinkAboutBldg Permit 01-1022
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
A~D UTILITY CONNECTION PERMIT
(Please type or print and si2ll at bottom)
ADDRESS
I L/ / I; ~
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Date Rec' d
1. White File
2. Pink City
3. Yellow Applicant
(l :i-~ I'VE...
LEGAL DESCRIPTION (office use only)
LOT h BLOC~ ADDITION kuc1 fJ ~f: 3 rd
PID '~5'-d...';-od{,-()
OWNER / J /' I
(Name) ----LLfLLr-?- ~ J.1-lih, S M I ftl-
(Address) ! ~/IlL.i (l~~~ Jt1OJ'\ /!./.. iV<
BUILDER i. / /) ~ r
(Name) ::::JQ.l~ ~ tvtJ1-IVl y CtM.J 3..,- (Phone) I.~ <7 L ?<;{"~t? ;r?CJ
(Contact Name) :1Y+~ (Phone)L,q tC}L,,/- 9~~
(Address) ~t':}5V- bl-rfv/<.J))r 1-Iwo i-AAs huV ~/.y' ftJctJ371/1
TYPE OF WORK
o New Construction
OLower Level Finish
o Misc.
(Phone) q5d--Y~q~/
DDeck
~e-Roofing
OAlteration
OUtility Connection
~~~
OPorch
o Fireplace
DAddition
PROJECT COST IV ALUE (excludinl} land) $
ORe-Siding
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 are 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 the pr t perform needed inspections.
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Permitv aluation
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
_I
71f.,75 I
I
I
I
I
I
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$
$
$
$
$
$
$
$
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This Application Becomes Your Building Permit When Approved
Building Official
Date
;; b1) 37/1, / .
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 ~ 7t. ,,0 ()
I Date ., Q - /f?-- /
#
#
#
#
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$
$
$
$
$
$
$
$
$
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Receipt No.'-IO ~ 10
Bvrx~ -
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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 LAK~
INSPECTION NOTlc.-e
SCHEDULED
9/i).7!tH A-0
ADDRESS
ILl I ~ 9
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
fJ I -Id2z-
o FOOTING
o FOUNDATION tf5\
o FRAMING ~
o INSULATION P-A
FINAL ::.u I
~ 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:
(/./ ~
~
,
)f WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTlON BEFORE COVERING
Inspector: ~ ,. Owner/Contr:
/
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI