HomeMy WebLinkAboutBldg Permit 01-1188
.l.Uf.l.1fUl U1U U;U7 t"AA 6U4474245
CITY OF PRIOR LAKE
lliaOl
Date Rec'd
'*lDLOY
q} =tu .
I PERMIT NO'I)
CITY 0", PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND lJ JILITY CONNECTION PERMIT
I. W1\l1c ,..
1. 'i.~ CIty
,. V.I",", Appl....
(Please tY{?C Of priAr and ,i~ .u bonom)
ADDRESS
L <3Q3 ) 4-0-rh f)-tYee+ N. V\J.
LEGAL OESCRu- uON (offiCI: \lIC only) O. .
LOT BLOCK ADOmON <t'JLlvl:t.. ;?-g
Plo.25-{lJg- ()()t.l- C, I
~~e~RCY I c-;+- MOrL-leD- AncteY00 n
(AddresS) 2 <i 5~ '14-0--tb P)+y-e-e--t- N. W .
C}5l.
(Phone) L.\ L/ cs. L4 I LP Z
(Sho..k.ope,~ - ~ LLi't'i d,~)
. '1_'
BUILDER \
(Name) P->u 4-0("'+ ~)( +e Y I 0 V 5
(Contact Name) . ArY1 be y G e 0 roe
v
(Address) ~O 1 q- N l C 0 \ I f>+- Ave ~
TYPE OF WORK
o Misc.
a New COIIICUc:riOll
(JI..ower Lc't'd Finish
(Phone) q~2. ?si5=t-- llJi I ~
~)92l-.?'"b"::}-. \ lo~
-\""0<\
ODd
(J Fireplace
Drorell
DAddilion
/'
~.RooftDl
[JAlteralion
PROJECT COST /VALUE (excludiftr:llDd) S
ORe.sidiDI
DUcility CoIUleClioa
A () ()() LO ~({J 4
- COUtlUtor's Licease No.
r Parle Support Fee
SAC
#
#
1 hereby eertify that I have fllmisbed informalion 011 this application wbic:it ,s to die best of my laJowlcdp trUe aDd comc:r. I also cenify tIlat IUD dle OMIS' or
luthOriZWd. aSeAt fbr the ahoYe-mentianed ~... ..., 1IId. d1at aU contcructiOll will coDfonn to aU WSMI .taW IIIcS toca1laws IDCl wilt ," , . . .1 iA I... .,1, JICII with
S\Ibmicred plins, I am aware that the bulldilll oft\cial an ",yolce thd permit for just eause. FardlemJon:. 1 bereby ."ee that the ci\)' aftSciaI or a daipee may
enter upon the property to ~ .,j, ,,,.., needed lospeclions.
X ().IYY\ b..QJ1 JUino 0 ,
. Si....tUre - J
I Permit Valuation
Permit Fee
Plan Check Fee
Seate Surcharge
Penalty
I Plumbing Permit Pee
Mechanical Permit Fee
Sewer a: Water Pmnit Fee
I Gas Fireplace Permit Fee
I
$ +y. (j).6
s
s 1/35
s
s
s
S
$
This AppllcaUon Becom.. Your Buildinl Pennlt W1Iea ApPfOwd
Bulldina OfJic:ial
D&tI
s
s
s
I s 70, O()
I ~~No. ~UI fL1/
Bv ,jc.-'
Warrr Meter Size S/8"; I";
Pressure Reducer
I Sewer/Water Connection fee
I Warer Tower Fee
Builder's Deposit
Other
TOTAL DUE
w
"
I Paid
I Date
~ "7/;' ,OU
J ('), - ~ ,-0 (
lo.\U\. d'
Dare
-
'$
$
S
S
,.
..
Thlt illO ca1lf)Ilhallh" rtqll"l in die alloYe appIic&tlon and KCompan)'a.a docuQlCJ\" II In acconlllftce witlllhe Qt)' ZcfllIIt OrdlIl_lIIIlll\llY prClCftd u teqUIRIlS. ThiI d, ....., ..11
wilen Dilled by tilt Cil7 P1anns caDSnruw II...... . '''. Ccrtiftc:alle of ZolIIt\a .. ..\.;:MlCuncl iIIoWI ecmllnlCllolllD .." ." ceo !tfore OCCII'UIC)'. a C4ft1ftareolOa:upAlllCY__
iallfd.
PllWlina DIlUtor
0. Spedll COIIditlou. if lilY
14 1I0ar a.dn for all iaspectiOlU (951) ....,-9t50. r.1t (951) 447-4145
it. .~~. " .~~ ,'"",-,'t
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
-2J>'S S
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
&F-PIffAL
o SITE INSPECTION
COMMENTS:
Le roo -;2
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~.
/'
/
~
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-:;
r 2' t/..j-e
, ,1 7~ TIME
SCHEDULED ~~
/tJ1(J ,<< i/
CONTR.
....
a/ - ,h/ Yt'
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
~ / /
~~/e/e
~
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V"WORK SATISFACTORY, PROCEED
(0 'cORRECT ACTION AND PROCEED
o CORRECT WJ~~>>:7R REINSPECTION BEFORE COVERING
Inspector: #?/7 ~ Owner/Contr:
,,' r
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
1NSN011