HomeMy WebLinkAboutBldg Permit 01-1128
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND' UTILITY CONNECTION PERMIT
L White File
2. Pink City
3. Yellow Applicant
(Please type or orint and sign at bottom)
ADDRESS 1/. '"'- / /
ICe .-/11 Vii c-f~/'I (\.
GrlJc S~
LEGAL DESCRIPTION (office use only)
LOT ;LBLOCK 3 ADDITION('P.JvLr/~ J ~!f>
CA'I 5
OWNER
(Name)
(Address) "? 1!'l./2~,-
Date Rec' d
PERMIT NO.O 1-;11J-~
)'P~Slr~)
PIDdS'" "3;).J""O/ t>-O
t.- 0 (J JC(Jl
. (Phone)
BUILDER I1 f} _ n (
(Name) VI. /Lfljt1dO<.....e In '/
(Contact Name) 3'0<... /l1or-e/l:;
(Address)
I TYPE OF WORK
o Misc.
2?G "'L(<(>
(Phone) t;t./?- 7 ~~ 7
(Phone) G ( z - 1./'7 () - zr;; C; C?
o New Construction
..----
~Roofing
~iding
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 needed inspections.
~/M-~t7Le~
/' Signature
x
I Permit Valuation
I Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
o Deck
OPorch
OLower Level Finish
o Fireplace
OAddition
OAlteration
PROJECT COST /V ALUE (excluding land) $
'1-07') }. S-7:>
Contractor's License No.
I
1 $ C-;Lf., 7~
I $
I $ I~;}~
1$
I $
I $
1$
j$
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTALDUE
This Application Becomes Your Building Permit When Approved
Building Official
I Paid 10 --~-l_\
I Date 7{P, Uu
Date
Ic/9/e'l
I { Date
# 1$
# 1$
I $
I $
# 1$
# I $
I $
I $
j$ 71;, , t'JU
Receipt No. 40 r;, - 16
Bv fY'./
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
ADDRESS
/ t, SI I
DATE
SCHEDULED Iz;l/~;61
I)'~ ~
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
A, ((
~
OWNER
CONTR.
PHONE NO.
PERMIT NO.
0/- i/ZY
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 EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
g ..J1",~
COMMENTS: ~--:.J
t&rrf
(Ip~ ~'-R 0
J/ WORK SATISFACTORY, PROCEED
(0 CORRECT ACTION AND PROCEED
::O:ECT ~ FOR REINS::,::.::FORE COVERING
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTl