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HomeMy WebLinkAboutBldg Permit 01-1122 (Please type or print and sign at bULMu) ADDRESS CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT Date Rec' d L White File I PERMIT NO .. 2. Pink City.. ~,; ,1_ J I., """\ 3. Yellow Applicant 'f I-L-d'"d' It 1L/q 1t>1/IVO TJ-; LEGAL DESCRIPTION (office use only) LOT~ BLOCK I i OWNER (Name) ADDITION /1-~lI/a dNcL 7 PIDdS-OO'1-() O~-6 ZOy!!:G (office use) (Phone) ~ f...l ' '1'11 - ~-'> ~.~ PiKe'r' fliLVTGIu /6 J l/ '? )/.;vN~ rrt L (Address) BUILDER (Name) I,- { ";/)0'- S fAil (Contact Name) R'IM f/{J!L (Address) I )... "3 ~ 2 l;?iI Sll<lt~.5S PA (l K /)1. tI 0 TYPE OF WORK o Misc. (Phone) 763'- 7/). ~ If'f)(s , (Phone) c; I) - 9l{{). '^- '? ill(- (C) o New Construction ODeck o Porch OAddition ORe-Roofing ~Siding OUtility Connection PROJECT COST IV ALUE (excluding land) $ 36,-;1) $ $ $ $ $ $ $ $ 7'1" /~ /" ~ 5 Park Support Fee SAC # # OLower Level Finish o Fireplace OAlteration 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 ~eeded inspections. X f--~ ...Ua 'H JI'7 /0/:;)01 . / Signature Contractor's License No. ' . Date Permit Valuation Permit Fee I Plan Check Fee I State Surcharge Penalty Plumbing Permit Fee Mechanical Permit Fee Sewer & Water Permit Fee Gas Fireplace Permit Fee I Water Meter Size 5/8"; I"; I Pressure Reducer I Sewer/Water Connection Fee Water Tower Fee # # Builder's Deposit Other TOTAL DUE This Application Becomes Your Building Permit When Approved I Paid I Date t~ . c?O- Jes--q- , I Receipt No. L./O b -, '1 I By I'tC J . . lJ Building Official Date '$ ~ $ $ $ $ $ $ $ $ 7&.u:J 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 SCHEDULED ADDRESS 16749 _ANNA 01-1122 Re-Side OWNER PHONE NO. o FOOTING o FOUNDATION o FRAMING o INSULATION o FINAL o SITE INSPECTION o PLUMBING Rl 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 ~IU: M;\.,lC:, r 1::.11::.1 .:>>Otl, Buildill~ Iilspector DEe "!J LUU] 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/ INSNon