HomeMy WebLinkAboutBldg Permit 01-1259
CITy'OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
]. White File
2. Pink City
3_ Yellow Applicant
Date Rec' d
II-r-o I
I
I PERMIT NO. ()/ -I 2,,59 I
I
WNING (office use)
(Please type or print and siJUI at bottom)
ADDRESS
1$9tR 6I(y/"^ltI.
{AI./-
LEGAL DESCRIPTION (office use only)
LOT/~BLOCK ~ADDITION ~~(vr\cL /)~ /~+-.
PID 25-/43 - ()35-0
OWNER ~ '* ~y' ~~'O~~
(Name)
(Address) 15~q U \SKy \ 1.\lL ~\lL
BUILDER &tJdPtU CoI'J6W~O~1
(Name)
~Ore - L/.th 6f (1YJnJ{oolA!...
(Address) t;
.r
(Phone)
(Phone)
Q6z J05 Ci,oO
TYPE OF WORK
o New Construction
OAddition
ODeck
OPorch
ORe-Roofing
o Misc.
OLower Level Finish
OAlteration
o Fireplace
.
.llRe-Siding
OUtility Connection
PROJECT COST/VALUE (excluding land) $ ,CJ'€l.t; eo
I hereby certifY that I have furnished inform tion 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 ioned operty and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans are th ,t the . aing official can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
enter u property to pe eeded inspections.
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
Contractor's License No.
$
$
$
$
$
$
$
$
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 #
Builder's Deposit
Other
10. ZS.CI
Date
$
$
$
$
$
$
$
$
$ 7~ . 0 0
'11'0 . 01J Recf/i i ~ +tJ 78 q
, II - r. 0 I By .J
. -
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and mW 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.
-1c..1.1r
{ . 1"r
This Application Becomes Your Building Permit When Approved
f~
Building Official
Planning Director
TOTAL DUE
/I-)"-cJ ,
I Paid
I Date
Date
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
CITY OF PRIOR LAKE
INSPECTION NOTICE
SGHEDULED
ADDRESS / :s~qjo 54 \ "'f'....
OWNER CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
o FINAL 0 PLUMBING FINAL
o SITE INSPECTION 0 MECH FINAL
COMMENTS: !5";(h, tL- Wio/'L<2W"
OK
Jo~e- .Q \<p ./
DATE TIME
:1-aI-D~ ,4T'
61-- ( l::;-q
I
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
/'
PORK SATISFACTORY, PROCEED
o CORRECT ACTIO ~ AND PROCEED
o CORRE",K CALL FOR REINSPECTION BEFORE COVERING
Inspector: .", \ ~ Owner/Contr:
CALL ~~850 FOR TH~ NEXT INSPECTION 24 HOURS IN ADVANCE.
~ .
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl