HomeMy WebLinkAboutBldg Permit 01-1047
Date Ret ''d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
~ ?'I3
1. White File
2. Pink City
3. Yellow Applicant
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LEGAL DESCRIPTION (offitt = 001,) /7 -
LOT 5 BLOC~ ADDITION ( (/~czIJ
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OWNER/f. -
(Name) -lw:... ~ * .J 6h V"\
. ,
s.c-h h.\ 1..-.
(Phonel'\S);-) t..H1-1-ULf
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
(Phone)
(Phone)
o New Construction
DDeck
ORe-Roofing
. jiM-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 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
~ter ~ .prr:'-to p.:.,:~uu nee . ns ctions. q -1--\ ~ 0 I
- ~ J Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
OPorch
OLower Level Finish
o Fireplace
OAddition
OAlteration
PROJECT COST/VALUE (excluding land) $
~
$ 7l./, '7S-
$
$ {'de;
$
$
$
$
$
I Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE
I Paid "$ -110 .()O
I Date C;- ::21-01
This Application Becomes Your Building Permit When Approved
Building Official
Date
#
#
#
#
$
$
$
$
$
$
$
$
$ -;~.oJ
Receipt No. LlOI,rY)
By Jr../
This is 10 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
INSPECTION NOTICE
DATE TIME
SCHEDULE~ //_ }/.",- / Lj;1JZ)
~64~ i1~cdAtioJv
o
/-/o!f/
CONTR.
ADDRESS
OWNER
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
J(1FINAL 0 PLUMBING FINAL
/cf SITE INSPECTION 0 MECH FINAL
COMMENTS: 1{..JV\I ~do _.... tfU..pO+
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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A A
(I fttra.<
-M
\2d WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT W~LL FOR REINSPECTION BEFORE COVERING
Inspector: vr I Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl