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HomeMy WebLinkAboutBldg Permit 01-1132 (Please type or print and sign at bottom) ADDRESS CITY OF PRIOR LAKE BUILDING PERMIT, TEMPORARY CERTIFICATE OF ZONING COMPLIANCE AND UTILITY CONNECTION PERMIT 5"d-7L/ ~ UVe- V~ LEGAL DESCRIPTION (office use only) ADDITION ~ m~ ~,+k Rl>J~D 5?. 74 C4.nJy (/Jvf... LOT BLOCK OWNER (Name) (Address) BUILDER (Name) (Contact Name) (Address) TYPE OF WORK I. White File 2. Pink City 3. Yenow Applicant . (phone) -r~.. ~.E.. (Phone) (Phone) o New Construction OAddition ODeck ~e-ROOfing OAlteration OPorch o Misc. OLower Level Finish PROJECT COST /V ALUE (excluding land) $ o Fireplace Date Rec' d PIIb2>-Oh~- /J~5-::-/ / q~7-- '-/L/1-Cf615 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 exnter upon t1;.r)p~~erform eeded inspections. '_~ /()II{)IJ / . Contractor's License No. ' rlate 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 $ $ $ $ $ $ 1$ I $ Park Support Fee SAC 1'1-1~ t/~~ Water Meter Size 5/8"; I"; I Pressure Reducer I Sewer/Water Connection Fee I Water Tower Fee I Builder's Deposit 1 Other I TOTAL DUE I Paid 7/>76 r ~ I Date io/ /0/ IfII / r This Application Becomes Your Building Permit When Approved Building Official Date # $ # $ $ $ # $ # $ I $ 1$ j$ 7~_60 o ' o;:} ReceiPt No. l.f'. (Od---' Bv <<-1 _____ u 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 SCHEDULED ADDRESS $~7'1 ~ ~ 12_ J OWNER CONTR. PHONE NO. PERMIT 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 HqgKUP o PLUMBI~INAL o MECH ~'AL COMMENTS: DATE TIME J~z/o' thJ ~ ~ TR.. Of - / I.:f Z o EX/GRAD/FILLING o COMPLAINT o FIREPLACE RI o FIREPLACE FINAL o GASLlNE AIR TST o J!. WORK SATISFACTORY, PROCEED o CORRECT ACTION AND PROCEED o CORRECT WO~AL~ FOR REINSPECTION BEFORE COVERING Inspector: l.W Owner/Contr: CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE. INSNOTl CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!