HomeMy WebLinkAboutBldg Permit 01-1070
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White File
2. Pink City
3. Yellow Applicant
(Please type or print and siJUl at bottom)
ADDRESS
}LlJ-17 SAuclybo~ ~)
I
LEGAL DESCRIPTION (office use only) 0 I.
LOlfr/~oCK ADDITION Jr6fJui 13.tcuJ-/
OWNER D... \ /"
(Name) t..-J 0 g K ~'--'- E'I . (Phone)
I
(Address)
)N C;.
BUILDER ~ -
(Name) '--M t) , N A-\.. E:~'-rcf,;(\ 0 <5
(Contact Name) ~'<'7 SJL-v ~ So N
(Address) -]'31 (', x.. r4-t ~ vi. VJ
TYPE OF WORK.
o Misc.
o New Construction
OLower Level Finish
(Phone)
(Phone)
S-~of'€.€-. (~,J
ODeck
OPorch
OAddition
--
.enfe- Roofing
PROJECT COST IV ALUE (excluding land) $
o Fireplace
OAlteration
PERMIT NO.a> /-1670
I
ZONING (office use)
R1SG
PIDJ~; (jjr- fJ01-D
tfLf~ - '-15"3 1
if'-l-') - 8 ,. 313
t./4<;'- 1S '3 ~
SS 3', q
ORe-Siding
OUtility Connection
~6~) au
o vO _
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.
X ~ <) ~~ _ ;2 C) :l;- 1 r 3 4-7 ~ -'1--1., -. 0 t
\ Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
$ 14- /~
$
$ J" ()..~
$
1$
1$
$
$
This Application Becomes Your Building Permit When Approved
Building Official
Date
I Park Support Fee
I SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
I Other
I TOTAL DUE
I Paid~ 7~ 00
I Date ~-~" -01
# '$
# $
$
$
# $
# $
$
$
$ 71:, .0()
,
Receipt No. tjui, ;;. J
BY~ L/
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
1-1- ~ _II?L:'
1!Ic)77~a4 &al'fi ~
CONTR. U
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDUL'fO
ADDRESS
OWNER
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION g C
p.., ,\,j.\.. J)oDr
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
(?f~ ~
(-/070
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORKytLL FOR REINSPECTION BEFORE COVERING
,'~l
Inspector: :./ '-) Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!