HomeMy WebLinkAboutBldg Permit 01-1062
CITY OF PRIOR LAKE BUILDING PERMIT,
~EMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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LEGAL DESCRIPTION (office use only)
LOT
F~
BLOCK
ADDITION
OWNER
(Name)
Date Rec' d
I. White File
2. Pink City
3. y.now Applicant
(t3
PID ~5"% -
(Phene)
(Address)
BUILDER 4J /?~ ~
(Name) ~
(Contact Name) F r ~ f)
,
(Address)
TYPE OF WORK
o New Construction
DLower Level Finish
o Misc.
(Phone)
(Phone)
65"1-777- 7/{11
6 /2 - !J- ~ i' - <9 67 S-
o Deck
~Re.Roofing
ORe-Siding
OPorch
o Fireplace
DAddition
DAlteration
DUtility Connection
73---
PROJECT 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 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. Ie r- I _ +J () _ l..-\.\ I
X ('j:~ ~ J.oo/r~ ~fiY 9'-)S--tJl
Signa Contractor's License No. Date
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
mes Your Building Permit When Approved
Q-'ls--o (
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ . "-==-~l.d...
.,:J '1)(""
I Paid
Date
(348/~
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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
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CITY OF .pRIOR LAKE
INSPECTION NOTICE
UAIt: TIME
ADDRESS
SCHEDULED / / .2I:J -()(
i/fus- ~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
/-llXo7
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
S 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
'\2- GASLlNE AIR TST
flX P-ov F
COMMENTS:
~~ \7k
p( WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
RK, CALL FOR REINSPECTION BEFORE COVERING
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI