HomeMy WebLinkAboutBldg Permit 01-1226
(Please type or print and sign at bottom)
ADDRESS
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
PERMIT NO.ot - J ;;..;--Ia
f/:;;}..-/ ~ P ILrtu leA)
Dr-
LEGAL DESCRIPTION (office use only)
LOTh BLOCK3 ADDITIO~ 11 /d4e (.rr
I
&~~R ~ J ~ J;rq.evJ::}' 0 J
J
(Address)
(Phone)
BUILDER. nl
(Name) OR 1'",,_MOd,e. \ Y.^fA
(Contact Name) .011 V.I 0/ IV 0 rjJ 1-'/', 11'
(Address) /:5?~'3ot ;;".bfirJ t~flt,j,f;
TYPE OF WORK
o Misc.
I Permit Valuation
I 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
ZONING (office use)
PUb
PID;:;S - ~ qq- 63 ;>-C>
(Phone) If fV L/f/7"? 5'9 .-)
. (prone)~/~ t{fj 5"'-7s3)
M'\)f)fL3,!ce AI/IV "'55Jl2~
o New Construction
pe-ROOfing
OAlteration
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
;~ropeAffians. W?~~j 533 11)/31/0 I
Signature V Contractor's License No. bate-
d5'Do.~
$ 'lit r~
$
$
$
$
$
$
$
o Deck
OPorch
OLower Level Finish
OAddition
o Fireplace
PROJECTCOST/VALUE (excluding land) $
/, J. 5'
I Park Support Fee
I SAC
I Water Meter Size 5/8"; 1";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid$l7~ I~' _
I Date //).- 210 - 0/
. .
This Application Becomes Your Building Permit When Approved
Building Official
Date
#
#
#
#
ORe-Siding
OUtility Connection
$
$
$
$
$
$
$
$
$
7~~
-~/\
Receipt No, _ ,,:/0//- /c./
BV tK!/
0"
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
CITY OF PRIOR LAKE
INSPECTION r...OTICE
ADDRESS
/6o-lcfY
OWNER
PHONE NO.
o FOOTING
o FOUNDA nON
o FRAMING
o INSULA TI9!>l? -P
~L /<:001
o SITE INSPECTION
COMMENTS:
DATE
SCHEDlkED // ,,- (
P a/t,h-/~u;--
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL A
o MECH FINAL
TIME
It./
1- / ri-d-0
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WO~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 & SAFETY!
INSlVOTI