HomeMy WebLinkAboutBldg Permit 01-1315
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ADDRESS
CI!.Y OF PRIOR LAKE BUILDING PERMIT,
TEMP.oRARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/
I. White File I PERMIT NO
2. Pink City '0/-
3. Yenow Applicant
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LEGAL DESCRIPTIO~ Joffice use opIy) d
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LOT BLOCK ADDITION
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BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
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o New Construction
OLower Level Finish
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(Phone)
(Phone)
ODeck
~e-ROOfing
OAlteration
o Porch
o Fireplace
OAddition
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
enter upon the property to perform needed inspections.
f(.LI~ %V~
l ~ignature
x
I Permit Valuation
I Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
PROJECT COST IV ALUE (excluding land) $
2-.500.00
$ 74--./'-1
$
$
$
$
$
$
$
I"U"
ecomes Your Building Permit When Approved
II-IQ-ol
Date
Contractor's License No.
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 'l1/J.O U
I Date ' ,I /-/9- () I
#
#
~/ /- ( 1 - () /
4rPate
.'
$
$
$
$
$
$
$
$
$
#
#
7tQ .00
. Rec~i . 4-tJtpZ-
By
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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
16200 Eagle Creek Avenue Prior Lake, MN 55372
CITY OF PRIOR LAKE
INSPECTION NOTICE
DATE TIME
SCHED"LED
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b,
ADDRESS
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CONTR,
OWNER
PHONE NO,
PERMIT NO.
t}(-J 3/ 5
o FOOTING
o FOUNDATION
o FRAMING
Ai INSULATION
FINAL
SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FilLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS: ~
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~ORK SATISFACTORY, PROCEED
o CORRECT ACTIO~ AND PROCEED
o CORRECT WORK, 'hAll FOR REINSPECTION BEFORE COVERING
,_r.-:p - \'.aM Owo.r.lComr.
CALL 447-9850 FOR THE:. NEXT INSPECTION 24 HOURS IN ADVANCE.
\
CODE REQUIREMENTS ARE FOR YOUR PERSONA!- HEALTH &: SAFETYl
INSNOTl