HomeMy WebLinkAboutBldg Permit 01-1207
(Please type or print and sign at bottom)
ADDRESS
3fo 70
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPO.R,ARV CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
3. Yellow Applicant
~{JJ{)cd (t~~s 0
o New Construction
OLower Level Finish
G -tIC
L
(phone)
(Phone)
(Phone)
o Deck
~ROOfing
OAlteration
PROJECT COST/VALUE (excluding land) $
o Fireplace
OPorch
OAddition
Date Rec' d
'~
PID ,;:;{\- ;JLIJ;-'-Ol(d--C/
,'l5d - ~ -.G6-1d
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
;ter upon the operty to per~rm n~:~ I ~ _ 01/. () /
r Signature - Contractor's License No. Date
LEGAL DESCRLt'uON (office use only)
LOT~l BLOCK L/ ADDITION I-,} I t2fJj!J1~r-(),/
/J /I '---
~'::e~R ~~AL1) JtA1Ir/~.V
I Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$ 7L/f' 7~
$
$ /, d~
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
Building Official
Date
I Park Support Fee
I SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
I Other
I TOTAL DUE
_f {/0
7lo ( -
1 (Y d-.Lf-v (
I Paid
I Date
# $
# $
$
$
# $
# $
$
$
$ 7braJ
~~yo r/-f1-
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
DATE TIME
SCHEDULED / / - J..-J-! It ~ L ..
t}(lMUX}()d ~
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
31.0 iO
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION (@
o FRAMING
o INSULATION
-a-FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
1<00 F
,. J
/AJIAJdoLLJ
_ r
-0lh
J-li70 1
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
( C ~ /~ V -f:' nJ/LXj--
!4 WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~LL FOR REINSPECTION BEFORE COVERING
Inspector: f' -r- l Owner/Contr:
J
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!