HomeMy WebLinkAboutBldg Permit 01-1095
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND lfrILITY CONNECTION PERMIT
I. White File
2. Pink City
3 . Yellow Applicant
PERMIT NO.
5532..
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LEGAL DESCRIPTION (office use only)
LOT& BLOCK ~DDITION
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OWNER
(Name)
(Phone)
(Address)
a;~)ER L~I d CC'-S.'fer.. [] u. ,Ie ~
Contact Name) /"\'/0..:.1- e J OJ ~ f
dress) 2-L/ 7ts- 4--edo .4v,( ~
-L,., c
(Phone)
(Phone)
612 ({C;O -Cjc.;OO
TYPE OF WORK
o New Construction
o Deck
o Porch
e-Roofing
DLower Level Finish
o Fireplace
DAddition
DAlteration
DMisc.
PROJECT COST IV ALUE (excluding land) $
e-Siding
DUtility Connection
I hereby certify that I have furnished information 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 prop and that all construction will conform to all existing state and local laws and will proceed in accordance with
e bu' . g official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
<<1m. ctiom. 202- 333 5J ~. -c)~,.".l~..
Contractor's License No. ~
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
~, 57Tl). CfV
$ 7 .7r-
$
$ /. z.-r-
$
$
$
$
$
Park Support Fee
SAC
#
#
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This A~PPli7~7 ;e=es ~ our Building Permit When Approved
I;t1!T IO~If~()1
BUI 'ng OffiCIal Date
$
$
$
$
$
$
$
$
$
.CIV
7~.CJO
/6 -~...cP I
I~~
I Paid
Date
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
(5532-
SCHEDULED L~/3tJfll
I r
(!~
A:-y--r
OWNER
CONTR.
PHONE NO.
PERMIT NO.
tJl-j()9s
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~ 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: s,'J).'::J J~H
rY~ ?-JL
~ WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
'",pecto" 5- ' Owne,/Cootr,
CALL 447-9850 FO THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH &: SAFETYl
J/VS/VOTI