HomeMy WebLinkAboutBldg Permit 01-1138
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File
2. Pink City
3. Yellow Applicant
PERMIT NO. CJI- //3 ~ I
,
(Please type or print and si'1;l1 at bottom)
ADDRESS 5& Lf ~
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c~
ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT~BLOCK 4 ADDITION &fl"lJ~ iRt'~ dMi pnbU"""-~-bl/o--(J
OWNER
(Name) .l1 etlyYIIL5 J.dl:~ (Phone) _t,/.L- ~o/CJ -.5J~/ ~
(Address)
BUILDER
(Name)
(Contact Name)
(Address) pjtJ
(Phone)
(Phone)
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TYPE OF WORK
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.
~~S;'
'--..::. ignature
o Misc.
x
I Permit Valuation
Permit Fee
Plan Check Fee
I State Surcharge
I Penalty
\ Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
o New Construction
ODeck
OPorch
OAddition
!i1Re- Roofing
ORe-Siding
OLower Level Finish
o Fireplace
OAlteration
PROJECT COST IV ALUE (excluding land) $
_)e:46 t#& J-
/O/'/t7 ~ J
, Date
Contractor's License No.
./'
$ 7'1,. 75
$
$ /-C).~
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
\ Water Tower Fee
Builder's Deposit
Other
# $
# $
$
$
# $
# $
$
$
$ '7& rOO
Receip!No. l!Obf b
. By ~ 4' .
I TOTAL DUE
This Application Becomes Your Building Permit When Approved
I Paid
I Date
lw,(JU
14-{~-o.l
Building Official
Date
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
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
5644
ADDRESS PAFQ(VIEVV
- 01-1138
OWNER Re-Roof
SCHEDlII Fn
PHONE NO.
. _.".1" ......,.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE Rl
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
.Cb.eSE FILE
Mike Pe I ~I .;)VII, Du;IJ;II~ IilSfJt::.(.1 VI-
DEe ',!. LDO]
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 .{ SAFETYI
lNSNOTl