HomeMy WebLinkAboutBldg Permit 01-1321
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
/1-2-0 -0 /
PERMIT NO. (J/-/5 ~
(Please type or print and si2ll at bottom)
ADDRESS
14-891 ~J ,An;; rftle-.
LEGAL DESCRl.t'uON (office use only)
ZONING (office use)
LOT
ADDITION SE,(!;f ~
PID 25" -q.30 - 0 U -0
BLOCK
OWNER
(Name)
KJ'~ L D fiHf..",
,
Smv7 6
J f::.;~
I
~ong,) ~";:i-~7 - ,;2 'j.if"j-
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 pi 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
~teru" thep ::~p';'i~v...:nee~;pections. 1.1-y.:uJ-o/
fl (f I.' ignature Contractor's License No. ',,{.-JDate
lj (' (
I Permit l'aluation 2-. .5'0 0 ~ 0 0 I Park Support Fee #
I Permit Fee $ tll 7) I SAC #
I Plan Check Fee $ __ I Water Meter Size 5/8"; I";
I State Surcharge $,. 2--r Pressure Reducer
I Penalty $ Sewer/Water Connection Fee
I Plumbing Permit Fee $ I Water Tower Fee
I Mechanical Permit Fee $ I Builder's Deposit
Sewer & Water Permit Fee $ I Other
Gas Fireplace Permit Fee $ I TOTAL DUE
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
ODeck
o Porch
OAddition
ORe-Roofing
o New Construction
o Lower Level Finish
o Fireplace
OAlteration
o Misc.
PROJECT COST IV ALUE (excluding land) $
#
#
ORe-Siding
OUtility Connection
$
$
$
$
$
$
$
$
$'1tp.dO
es Your Building Permit When Approved
Paid 1 t,. (j])
Date' /1, () 4 .--rJ}
R=r~:?'
By . .
11-))0'0 I
Date
, 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
ADDRESS
1<1 ?? /
DATE TIME
SCHEDt;.ED /~ A.""t-"
~~,
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
OI-/3Z I
o FOOTING
o FOUNDATION
o FRAMING
IJ INSULATION
ill FINAL
,.j SITE INSPECTION
COMMENTS: ~~
,
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADfFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
pORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: a Owner/Contr:
CALL 447~8'O FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI