HomeMy WebLinkAboutBldg Permit 01-1040 Re-Side
09/06/01 TBU 09:40 FAX 6124474245
CI_~ OF PRIOR LAKE
IaI 001
CITY OF PRIOR LAKE BUILDING PERMIT.
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION pERMIT
Date Rcc' d
q~2 0-0/
~. E. =,-. \ PEllMIT NO.O / -104-0 J
j \~~-J 1
(Please ~ Ofl!!!!t and siD at ~
AP~0~:::- Mf Ave Sf. ).
LEGAL DESCRIP'l10N (omc:c '* only)
LOT 'Z---BLOCK. {ADDITION WI UfJ WS 4-1lt
pm 25-1/3- 002.-0
=:-~~;+~(~~~Jk- ,
(AM=sl/&_S ___ ,A; 50 ,t.y ~,rnlo.!
. Bt.m.DElt/ .
(Narne),.:f.- -~~~(' S
(Contact Name) .br~~ ~Af...MS. GO'X' ~(."-~(
(AddreSS>:3rtO /tJ. Jfw /3 fbur(J5V11 k- Yl?AI ~s:
I hereby ~ that J uve (umisbec1laforraatior1 011 dais 1PP1icadoD whidl is to the best of my kl\owIedIC tnJe aod cmm:t. I also certify dW I a1ll the oMllll' or
audloaized qa\t for the .bovc-~ propertY ud daat all ~ trill coafona to all exiJliaC state 1DCl1oc.11aws and wiD procce4 ill aa:or4mcc ~
submitted p\aDl. I aID aware that 1bI buildiDI oftlcial CIJlleYoke daD permit for just a,*- Punbenaorc, I bereby a~ dlar die eity oftic:ial or a cIesipee may
enta' lIle neeckd inIpedioDs. 9'1 1/1 /'01
d.{jJ35(/nf'~ IL'*l/t._
CoDtnCtor's LiceGJe No. ' I Da1e
TYPE OF WOlUC.
o New C()ftSbUCdDll
OLower Level ymisb
[JDeck
o Misc.
permit Valuation ;2,SVV.ffl)
Permit Pee S '7t.f. 7 r
Plan Check Pee S - -
Scate Surcharge S /. Z,s
Penalty S
Plumbing pennit Fee: S
Mechanical Permit Fee S
Sewer &; Wau:r Pennit Pee S
Gas Fireplace Permit Fee S
r-~p-~~J
'I Otlldal Date
(phone) q~d- '-I'I() ~ 71137
5S37~
1
~
(Phone) 9:;~,)f~: :76dD
(phone)
/
QPon:b
idiac
OUdlltJ CoDaeccioD
.9~
Park Support Fee ## S
SAC ## S
Watl/% Meter Siz!! 5/8"; 1"; $
Pressure lleducer S
Sewer/Water Connection Fee 1# S
Watel' Tower Fee ## S
BuUcScr's Deposit S
Other S
TOTAL DUE S -?~. 0 0
~~d- 1
~aid 1'~
Date - - 0 J
.
'nil is tb ~ify dIIt dtc n:qUeIt in tbe a\loft: applicldoa pd aC1CC)111J111171 doClamentl is IIlllXordaIlc:e with ~ CIlJ ZorWII ()rdinanCI1IIlI may IJIOCftd u requesllllL 'Ibis doCUlIlCIlI
when sipcd by die Cky Planner cDlll1i..,es a ,eatpODIJ1 CedifiCan: of Zoallla CXJIIlpIIaIltt md allowS cC)lllUUCtloa '0 ~ IldOR 0CDJIlIIICJ. a c:enIJicaIz of 0a:IIpUICJ MIlS' be
btual
PI..nin& Dircc:tOf
0. Specl.. ConcIifJonS. If Ill)'
l' hoar ROtice for .U IllspectiON (951) .41.9850, f.x (!JS) 447-4145
--~"'"-~_.,.._,---~~-~,~--~_.---..+-...~_."~~,..,~~_..,...
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
16725
BAY
01-1040
Re-Side
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
tAD/FILLING
u l,;umPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
CLOSE FILE
,v,ike Pe I er'Sutl, Builditlg In5pecto'~
Dee 2 2003
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH .{ SAFETYl
/NSNOTl