HomeMy WebLinkAboutBldg Permit 01-1119
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
3 4-eJ /
1. White File
2. Pink City
3 . Yellow Applicant
WItA/ol1/ 1>131CW Te-.
LEGAL DESCRIPTION (office use only)
~-4 /J' ,....;- /7
LOT BLOCK ADDITION,J / vtJ/!' A ('-"
OWNER
(Name)
(Address)
(Name) Xr<-U.str &-f1()C/
(Contact Na~e; /Vl J'.k,Q ~ J
ress) 30~ kJ aD ofh Sf
TYPE OF WORK
o Misc.
o New Construction
OLower Level Finish
72 L ~.-tf: 88'
(Phone)
(Phone)
(Phone)
:::JO Y c/ a'l')
o Deck
o Porch
OAddition
~-ROOfing
OAlteration
PROJECT COST IV ALUE (excluding land) $
o Fireplace
PID z.5 - /07- 003 - 0
wa -3fvd
,
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
enter upon the property to perform ne d inspections.
X ~/L/~V- .'
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
$
$
$
$
$
$
$
$
;J.~#'(JV
7t1. 1S-
-
/. G.-S
This Application Becomes Your Building Permit When Approved
Building Official
Date
Contractor's License No.
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1 It;
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE
I Paid
I Date
7Jd) ()
J 0 -9-0 ,
#
#
#
#
$
$
$
$
$
$
$
$
$ I~. 0 C
Recei/ltl- 4Ofl73
By f
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
ADDRESS
3481
WILLOW BEACH
01-1119
Re-Roof
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o 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 GAS LINE AIR TST
o
COMMENTS:
CLOSE FILE
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OEl
~. ')00':;
l' 1.. ;:.
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
. Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl