HomeMy WebLinkAboutBldg Permit 01-1084
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bv~~"u.)
ADDRESS
I. White File
2. Pink City
3. Y eliow Applicant
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LEG,,#ESCRIPTION (office use only)
LOT ~~OCK ADDITION a~ Wot.tl~
OWNER
(Name)
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
Date Rec' d
PERMIT NOW_ J()g(j
ZONING (office use)
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PID ,;JS- 0;)9- {} (7r(~
(Phone) q~7" t.f_5~'
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r;~~\ In 11 St,
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(Phone) yg,;;. . 3/''-I cd
(Phone)
o New Construction
~fing
OAlteration
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 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
;teruponthe~eeiiU;;~/L/ ::;;JCJ{ a:!;i 7S- !{J - ;)-0 (
Signature Contractor's License No. ' Date .
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I Permit Valuation
I Permit Fee
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
o Deck
OPorch
OAddition
OLower Level Finish
o Fireplace
PROJECT COST /V ALUE (excluding land) $
$ 7'1- 75"
$
$
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size 5/8"; }";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid "7f(J .OU
I Date . 10 --J-- I
/.;;J.5
This Application Becomes Your Building Permit When Approved
Building Official
Date
# $
# $
$
$
# $
# $
$
$
$ /~.C()
II (r)/.??('
Receil?t N Q7 V IV .::J
By gv-
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
5(j $56
DATE TIME
SCHEDULED ft!/Z.~I . A. 1((
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CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
CJ I - /6 r'-/
o FOOTING
o FOUNDATION
Y FRAMING
o INSULATION
o 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
o GASLlNE AIR TST
o
COMMENTS: I ~ -- 0- J '
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o WORK SATISFACTORY, PROCEED
~ CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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Inspector:
Owner/Contr:
\,;..0'" ~I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl