HomeMy WebLinkAboutBldg Permit 01-1313
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and si~ at bottom)
ADDRESS
Date Rec' d
1. White File
2. Pink City
3. Yellow Applicant
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LEGAL DESCRIPTION (office use only)
LOT ~LOCK3 ADDITION1J~
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(Address) /10 IJb I~ (JaiJr> d 4t' C, / S. (,
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BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o New Construction
OLower Level Finish
o Misc.
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(Phone) _~5 d;-) L)CLIJ~/7C/~
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(Phone)
(Phone)
o Deck
o Porch
~Re-ROOfing
OAlteration
o Fireplace
OAddition
PROJECT COST/VALUE (excluding land) $
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 th bove-mentioned property and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted plans. I ware that th uilding official can revoke this permit for just cause. Furthermore, I hereby agree that the city 0 'al or a signee may
:ter upon c..v to pe ded ins~s.
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I Permit Yaluation ;;l..S-6D
I Permit Fee $ 7l/r 15'"
I Plan Check Fee $
I State Surcharge $ /" ;).~.
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
$
$
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
This Application Becomes Your Building Permit When Approved
Building Official
Date
Contractor's License No.
I Park Support Fee
I SAC
I WaterMeter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid fP/7 fr.. ~.f)
I Date I - I lA-I') I
#
#
#
#
ORe-Siding
OUtility Connection
Date
$
$
$
$
$
$
$
$
$
..
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Receipt Noj-IO rj d--1
By crr"'_/
This is to cenify 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 Cenificate 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
16200 Eagle Creek Avenue Prior Lake, MN 55372
ADDRESS
~66~
DATE TIME
SCHEDULED .. }h j;.k.s-
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CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
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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 EXIGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
COMMENTS:
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~WORKSATlSFA\'IV"" rfteC;:;:::; -------
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL F R 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!
IN$/<<JTI