HomeMy WebLinkAboutBldg Permit 01-1079
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
7- 21"() /
I. White File
2. Pink City
3 . Yellow Applicant
PERMIT NO. 0/- /07Q
I
ZONING (office use)
/<::4
(Please type or print and si~ at bottom)
ADDRESS
5(,7/ ~(/Jf~NO~ s--j'
LEGAL DESCRIPTION (office use only)
LOT/2.BLOCK,3 ADDITION M20/N/tt- /2IOGJ6 2.f/o
PID~-302--()n-o
OWNER
(Name)
(Phone)
(Address)
rJ"."
1 I BUILDE~ . I' . /1 /7 {I /" 'L.. .A "'#.....
ii (Name))'trttfl€l Cfk.-~F/1taJLP //~ L67vl ,en:e..;'~/P~
I: (Contact Name) fVt r "t""y '-.J
I' (Address) /~ l( I 5 6;1 .... .Ii..- ~ /Jv(a.
II .' ,
(Phone) 61;2"'770-/',/1 ~
(Phone)5~
/2o.s~~I1-.-,. 5::-\tJhf-
TYPE OF WORK
o New Construction
o Deck
OPorch
OAddition
ORe-Roofing
-
~e-Siding
OUtility Connection
OLower Level Finish
o Fireplace
OAlteration
o Misc,
PROJECTCOST/VALUE (exc1udingland) $
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
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 th 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 0 cial revoke this permit for just cause. Furthermore, I hereby agree that the city o~cial r a~si e may
enter upon the property to perform ,eded il\sp on /",. r" ~ }-P; 0/
X \ //1/\ /1.- ? \ '~V"'"'-'-'l ~
Mig/(ature - A- Contractor's License No, ate
r --
. Z. ~OO .%7J I I Park Support Fee # $
$ 7tf-.7r I I SAC # $
$ .-- I Water Meter Size 5/8"; 1"; $
$ I . z.,.r I Pressure Reducer $
$ Sewer/Water Connection Fee # $
$ Water Tower Fee # $
$ I Builder's Deposit $
$ I Other $
$ I TOTAL DUE $
Permit Valuation
Permit Fee
Th;'App_~Whon_
.1 offid~ 'f~:r - d I
I Paid
I Date
-
'/(, ,nu
1-?~.'
'f(p .tJO
f/1
Receip ? /jf;~ ?-
By ~ _ .
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
ADDRESS
S~7/
DATE TIME
SCHEDULED / () -I"'! If ' r:
-'~J
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
/- /079
o FOOTING
g ~~:~NA;IONrEJ
o INSULATION K
~ FINAL
o SITE INSPEC ON
COMMENTS: tS
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PI,.UMBING FINAL
o ~H FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
ft WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
::~:O:ECT wo~ ~OR REINS:::,::FORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI