HomeMy WebLinkAboutBldg Permit 01-1080
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3 . Yellow Applicant
PERMIT NO. ()I- / D ~ D
(Please type or print and sign at bv..v...)
ADDRESS
(pO{p 'f /5071l..sT
.sE,
LEGAL DESCRIPTION (office use only)
LOT (p BLOCK 7 ADDITION
OWNER
(Name)
ErJ.:::> I N 000
KAZ//01/ q~Oee;6
s~H6
(Phone)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
(Phone)
(Phone)
o New Construction
ODeck
o Porch
~e-ROOfing
OAlteration
ZONING (office use)
R../SD
PID 25-1/7-QQ/&J-n
441-(02/5"
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 plans. I m 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 pr erty ~~ee~e# inspections. / . I
X .2.~ 9/~/c/
Silnature Contractor's License No. ' Date I
1
,
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
Penalty
Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
OLower Level Finish
o Fireplace
OAddition
PROJECT COST /V ALUE (excluding land) $
2,500.00'/
$ 74-; 75
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
Pressure Reducer
J.ZO-
Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE
I Paid . jf/') , DV
I Date q -- ::;.x--nJ
, ,
ecomes Your Building Permit When Approved
Date
#
#
#
#
$
$
$
$
$
$
$
$
$ '1(,. () 0
ReceiPtNo~. //()~G
Bv U
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
INSPECTION NOTICE
DATE TIME
SCHEDULED ~~~~~
, r f
/<;n~ sl
ADDRESS
~ {)t,/
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
A-FlNAL
o SITE INSPECTION
COMMENTS:
/J (/
/Lest de-
CONTR.
PERMIT NO.
/1/-/ofc)
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
/7 / '/
Lo~# /e-7e....
/
~
/'
/ ./1/J
\. /,__/0,) -e.-
~-
~
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)
,(WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR EINSPECTION BEFORE COVERING
~
, /'
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
Inspector:
..//
h/e
----
Owner/Contr:
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETY!
INSliOTl