HomeMy WebLinkAboutBldg Permit 01-1135
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORAR);.CERTIFICATE OF ZONING COMPLIANCE
...
AND UTILITY CONNECTION PERMIT
Date Rec' d
1. White File
2. Pink City
3 . Yellow Applicant
PERMITNOrY/_ 1135' I
(Please type or print and sign at bottom)
ADDRESS
s-cJ..? 0 CAt2tJ ;,J-I1-L
,ltl/? ~L
. ZONING (office use)
IJuo
LEGAL DESCR!YIION (office use only) \
LOT}~BLOCK I ADDITIO~d 1f/~J/)n..Js-:I pu:6(Z;- ;(c;q-O/5-LJ1
. ~'~
OWNER'"'
(Name) .tJ.o1V1t/d tJ/4-, . (Phone)
,
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.
X ~~
I Permit Valuation
I Permit Fee
I Plan Check Fee
State Surcharge
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
.th11tX' ~. Yf,
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)
TYPE OF WORK
o New Construction
ODeck
OPorch
OAddition
ORe-Roofing
OLower Level Finish
o Fireplace
OAlteration
o Misc.
PROJECT COST IV ALUE (excluding land) $
do/6 tlf/OJ.
Contractor's License No.
Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
7'1 7~
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
Builder's Deposit
#
#
/ { ;;J.. S-
#
#
Other
l TOTAL DUE
This Application Becomes Your Building Permit When Approved
I Paid 1 ~-,t.( 0-0/
I Date 9fJ1" ,00
Building Official
Date
7% g-- /J.<lcl
/&IRe-Siding
OUtility Connection
/0 M 1, /
. rfatol'
$
$
$
$
$
$
$
$
$ 7~40
}-'OJ (7/
R.ece.lip tNo. Y( tjOP
By (H /
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
J /-C)..)-/ FI., r:
. ,
5 930 ~~ IR /dc;,p d-"-
u-
!-1/3S-
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDA nON
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
~~~{de,
I ,.
~
COMMENTS:
DATE TIME
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
'ct!WORK SATISFACTORY, PROCEED
(0'" CORRECT ACTION AND PROCEED
o CORRECT WOp;}' CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~f Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl