HomeMy WebLinkAboutBldg Permit 01-1127
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ADDRESS / /,
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CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND,YTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yellow Applicant
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LEGAL DESCRIPTION (office use only)
LOT ~LOCK S- ADDlTIO~tf-f ~ LftI-
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OWNER
(Name)
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(Phone)
(Address)
a:;~)ER 0/'1 l2e%lC)~~n 7
(Contact Name) 36..f jI}/f GC'e;-;'
(Address) I )~2 "3 '7 ~qlrt4'1k> Ie. 1/
TYPE OF WORK
o Misc.
(Phone)
(Phone)
a/Up' (q/~
o New Construction
~oofing
Date Rec'd
PlDdS -- 31'-1--{) ~f-O
t!t.17-77~i
YFL - 7"97 - 7::>'I? 7
4>rL - Y70 - U 'f~
-
DUtility Connection
9, /to 0 (..0
PROJECT COST IV ALUE (excluding land) $ f, (/
I
-z 0 z 3'y!:""J7
Contractor's License No.
$ '7tf- I~
$
$ /'d-.5
I $
I $
1 $
1$
1 $
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
DDeck
o Porch
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 needed inspections.
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f ,/ Si~ture
. Permit Valuation
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
DLower Level Finish
o Fireplace
DAddition
DAlteration
This Application Becomes Your Building Permit When Approved
Paid
Date
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lo-q-I
Building Official
Date
#
#
#
#
/~~/O/
Date
$
$
$
$
$
$
I $
1$
I $ 7~,{}O
Receipt No. LlO b r /0
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By
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 consttuction 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
/I-?-O/ It!'
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CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO. PERMIT NO.
D FOOTING ~ D PLUMBING RI
D FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
D INSULA T19N- J I ~~ C D SEWER HOOKUP
.....e-FfNAL :5 }tJ or 0 PLUMBING FINAL
D SITE INSPECTION (1 0 MECH FINAL
COMMENTS:
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o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
D FIREPLACE FINAL
o GASLlNE AIR TST
D
>' WORK SATISFACTORY, PROCEED
D CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
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CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl