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