HomeMy WebLinkAboutBldg Permit 01-1065
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND~UTILITY CONNECTION PERMIT
Date Rec' d
(Please type or print and si2l1 at bottom)
ADDRESS
~. ~i~i~e ~~~ I PERMIT NOoA,/_ I/) ~ (- "
3. Yellow Applicant (/, IVr Ij.J
,137/
A~~ ,-fA.)
LEGAL DESCRIPTION (office use only)
LOT
ADDITION PLS 3"0
BLOCK
OWNER
(Name) 0 ~M
(Address)
/A)ork/hCl/
~-
. (Phone) t../ t-/? - C? 706
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
o Deck
OPorch
OAddition
~-Roofing
OLower Level Finish
o Fireplace
OAlteration
o Mise,
PROJECTCOST/VALUE (excluding land) $
ZR7soceuse>
PID~S-IOIo-~
ORe-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 Pla~;p;t;ware that the bUildin:e:~canre this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;~,"Pt::;~?;p~Zi.//u/~ 9-2-5 -t) I
Signature Contractor's License No, Date
Permit Valuation I
Permit Fee 1$ 7'1,7"5'
I Plan Check Fee 1$
I State Surcharge I $ I"d)
I Penalty 1$
Plumbing Permit Fee I $
Mechanical Permit Fee 1$
I Sewer & Water Permit Fee 1 $
I Gas Fireplace Permit Fee I $
Park Support Fee
SAC
#
#
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
I Other
I TOTAL DUE
#
#
This Application Becomes Your Building Permit When Approved
I Paid
I Date
'1ft:, .00
" ,. n- t::; -0 I
Building Official
Date
I $
1 $
I $
j$
1 $
I $
1 $
I $
I $ 7(:; ,00
\.
Receipt No. L/IJ /'" rl.C)
By rd' ./ . -
(j~
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
CITY OF PRIOR LAKE
INSfiECTlON NOTICE
SCHEDULED
ADDRESS
r337 I
~/"
-/
CONTR.
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION@
o FRAMING
o INSULA nON
~ FINAL
o SITE INSPECTION
COMMENTS: ~
o
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
-
(~
~
DATE TIME
/1 blaJ.
/ .
~ Ie,.
ItJ.'(J()
tJ 1 - / {J &,..5
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO"LL FOR REINSPECTION BEFORE COVERING
Inspector: . ~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!