HomeMy WebLinkAboutBldg Permit 01-1220
(Please type or print and silm at bottom)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
I. White File
2. Pink City
J. Yellow Applicant
Date Rec' d
I PERMIT NO.of-.
;)~"l ~!?O Rd
LEGAL DESCRIPTION (office use only) A )
LOT BLOCK ADDITION ~/na-;-btlf1~
d,)/3
OWNER
(Name)
'-..TI ;v, t!-/ /i it-
c:Js7 3 S fJ~~~ L~/<p
(Address)
PID~S- J3/-/YJ3-0
(Phone) C;S:).- 4lf~- 30&1
lU
BUILDER / ~ /1 1/"],1/1 ." I . I .
(Name) t..-()("e./t wtl ire- U//-~..v cf JlcU"<:';
io f'8v1 tUtJ ik
Lfl/t tlat/ey ~CL /tV) ,~~
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
(Phone) t:/.sCf - L/~6 --/~06
(Phone)L:/d - LffO-oso
~'k~
o New Construction
o Porch
DAddition
~-ROOfing
DAlteration
~-Siding
DUti1ity Connection
I hereby certify tha 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 r the above-mentioned prope and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted . am a .w.arfjthe u' ain fficial can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter up . ~~fjt~pn ons.
'%M {! LfB.s~ !tJ-dLj-C/
Si Contractor's License No. Date
Permit Valuation
Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
o Deck
DLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
$ 7lf, 15
$
$ l.;}5""
$
$
$
$
$
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
I Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
'. C/J
I PaidlJ '74,
I Date I ()/ J4 () I
Building Official
Date
#
#
#
#
$
$
$
$
$
$
$
$ .A
$ '7ft; /b-
. , I
Receipt No.WOr/lPY
By CJC-./' I
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
CITY OF PRIOR LAKE ~ A
INSPECTION NOTICE SCHEDULED ~-?/ a..s--
ADDRESS ~S/? :Yr0.f ~...{e
OWNER CONTR.
PHONE NO.
PERMIT NO.
~-/..:2~
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
/J /} ./J ~ /
k/tJO f' 'j- fes Ide
/'? 4 /
Co~/~ re..
,
~ -----
~ ^'.
./ ......,.... . ..,.,-- r)
~RK~2.r:::: ~ ~
o CORRECT ACTION AND PROCEED
o CORRECT WO~R';, ~~R REINSPECTION BEFORE COVERING
Inspector: ~7 Owner/Contr:
)
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl