HomeMy WebLinkAboutBldg Permit 01-1157
(Please type or print and siAA at bottom)
ADDRESS
)607;;1 't1' Ast1A
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
1. White File
2. Pink City
3 . Yellow Applicant
Date Rec'd
I PERMIT NO(!) I
~t
~v-e.
LEGAL DESCRIPTION (office use only)
LOr-? BLOCK (J-, ADDITIO~ b U~ fc-tA
. . - '"
OWNER ~
(Name) c::v/e:.a.H
(Address) 14.:<'2 7
BUILDER
(N ame)
(Contact Name)
(Address)
TYPE OF WORK.
o Misc.
ING (office use)
Rt
PIDd5"-/g1-OdI-C
~_k
$fA~l!A.
(phone) (q 5 ~) .1 s' J - ';;;00/ S""
LA I<.p J11 nJ S- ~~ '7 .:<.
I~ V f.
?Il ; 1)/1
~e-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
enter upon the property to perform needed inspections.
x
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
(Phone)
(Phone)
o New Construction
o Deck
OPorch
ORe-Roofing
OLower Level Finish
o Fireplace
OAddition
OAIteration
PROJECTCOST/VALUE (excluding land) $
Signature
-
~&.,/ ~tractor's License No.
$ 7J!,. 7K
$
$ I"d~
$
$
$
$
$
I Park Support Fee
I SAC
I WaterMeter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
.. 00
VII",.
la-/5VI
Building Official
Date
#
#
#
#
Date .IlJhrJ:;dJJ
. ,
$
$
$
$
$
$
$
$ Li)
$ 1ft,.
Receipt No. Ll07 cID
By F
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, ifany
24 hour notice for all inspections (952) 447-9850, fax (952) 4474245
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
16227
IT ASCA
01-1157
Re-Side
SCHEDULED
ADDRESS
OWNER
PHONE 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 HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
~b.05~ F!~~
N,ike P~'h:.rson, Building Inspector
ut:.t. Z Luu3
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 de SAFETY!
INSNOTl