HomeMy WebLinkAboutBldg Permit 01-1089
09/27/01 THll 14:54 FAX 6124474245
CITY OF PRIOR LAKE
I4J 003
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERIUICATE OF ZONING COMPLIANCE
AND lJ .llLITY CONNECTION PERMIT
Date Reo' d
/0 . 'Z -0 /
I. While Pile
2. Piak City
3. Yellow AppliCIDI
ZONING (offil:e llse)
~
(!'Iease tv;2e or tlrinl: and S~~'l'''~) L
. ADDRESS a A } T
.sZ~5 /611) 7H
, -'
.5:T S~
LEGAL DESCRJr liON (office use omy)
LOT
BLOCK
ADDITION ;{ILLS8Ub.! 7f)WNHdHF",....5
, t' ..- .
..
PID ~...357- O()/-o
OWNER
(Name)
(Address)
;6:;~~~ClA ~'"Q I~) ^. \S~i~ lA<?r' ~ ~A{
(Contact Name) ~",^, ~ r<"\ I.) ^-
(Address) I q / '/ (;; e.'/VI.A..Ir... -J,Jo Qa (Ad'" Q
, (phone)
(Phone) to S" J .3 Bi-93l/ 0
(phone) &S-/ 'l.?,/-,LC,o
TYPE OF WORK
o New ConstNC1ion
DLower Level Finish
""II... \ S.\" 1 ~ a.
.
DDeck DPorch ~-Roofing ORe.SidiDg
o Fireplace OAddition OAlteration OUtili~ Connection
o Misc,
PRomer COST /VALUE (excluding land) S
I hereby certi1Y that I have furnished information on this application which i, to the besr of my knowledge ENe and comet. I also certifY that I am the owner or
authorized aa=t for me above.mentioned property and that all consauction will conform to all exisring srate anc1locallaws and will proceed in accordance with
submir:red plans. I am aware that the building official can revoke this permit for just cause. Furthermore, I hereby agree lhat me city official or a deslgllee may
~ the r' ~ r.' erfi needed ill.5peCtioD5. I
X J .~ ~ OD S- 7 9 A '7 /0 / 1 G I
Con~r', Lic:cnseNo. )<Dare
# $
# $
$
S
S
S
$
S
S
Sewer &: Water Pennit Fee
2.~ 50 0.00
s 7+. 7S
s
$
S
$
S
$
S
I Park Support Fee
I SAC
-Water Meter Size S/8"; 1";
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
rZS
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
~~ TlU$ AW,~/A/f~OV Building Permit When Approved
U/~ /d.Z,.d/
Building Official Dare
Paid
Date
- -
'lr~. (JL)
_/~..O/
714 . 0 0
RC~ ~(,~
Bv/ r /\
. Gas Fireplace Permit Fee
TOTAL DUE
This is to certify tlw the request in !he above application md aceompanylftg doc:urnmt!I is in accordance with the City ZoIIing Ordinance and may proceed ill n:quesled. This doc:ument
wh.m signed by the City Planner eonsdrures a "'ur .".~ Ccnifican: of Zonillg complimce lIDd aDows conscnsClioll to c:omllll:llce. Bel'ore OCOlJIancy. a Certificate or Oecupancy mUll be
i.5SuecL
Phmning DI~r
Dab: Special Conditions. if any
:14 hour noti~e for all inspectlons (951) 447-9850, fax (951) 447-4145
DATE TIME
ADDRESS
~-al//
SCHEDULED 10 -9- ,
) ~OlX S-f-
It. T-
CITY OF PRIOR LAKE
INSPECTION NOTICE
PHONE NO.
PERMIT NO.
/ _ /Jf'?
J- 1070
OWNER
CONTR.
o FOOTING ~ 0 PLUMBING RI 0 EXlGRAD'FILLlNG
o FOUNDATION 0 MECH RI 0 COMPLAINT
o FRAMING 0 WATER HOOKUP 0 FIREPLACE RI
o INSULA~ 0 SE~R HOOKUP 0 FIREPLACE FINAL
X~INAL d 0 PLUMBING FINAL 0 GASLINE AIR TST
o SITE IN PECTION r 0 MECH FINAL 0
COMMENTS: &~ 9J~ ~ ~ at:::
'- If';;) 4/ {/ (/V
(if P1U-
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl