HomeMy WebLinkAboutBldg Permit 01-1038
(Please type or print and si~ at bottom)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/4-.52/ SHot=.-6
1. White File
2. Pink City
3. Yellow Applicant
L-A IV' 6
N6
Date Rec' d
9- 20- 0/
I PERMIT NO.O/_! 03~
ZONING (office use)
Pt/SD
LEGAL DESCRI.t'TlON (office use only)
LOT I BLOCK '7 ADDITION 6ANO PO/NT 4111 /lVD;J PID2S-2/5-0QS-Q
OWNER
(Name)
/Vl/lRA/ LGW/S
,
Sri t^-1 G
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
x
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
o New Construction
OLower Level Finish
(Phone) 252-44?t;,-320s...
(Phone)
(Phone)
o Deck
~
)(Re-ROOfing
OAlteration
o Porch
PROJECT COST IV ALUE (excluding land) $
o Fireplace
OAddition
2~500. 00
$ 74.75
$ .
$ /. zs-
$
$
$
$
$
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 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 the property to perform needed inspections.
~A.d ~~--o.
~e----
Date
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
Water Tower Fee
Builder's Deposit
I Other
I TOTAL DUE
I Paid '7(,. () 0
I Date ' .(j - 21} - /) I
, .
ORe-Siding
OUtility Connection
9/1,;;,
Date
# $
# $
$
$
# $
# $
$
$
$ 7&. 00
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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 LAKE
INSPECTION NOTICE
14 )'2.1
SHORE
01-1038
Re-Roof
SCHEDULED
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o 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' GAS LINE AIR TST
o
COMMENTS:
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(j'CT ~ 1.Q~~
o 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!
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