HomeMy WebLinkAboutBldg Permit 01-1202
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and si~ at bottom)
. ADDRESS
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1. White File
2. Pink City
3. Yellow Applicant
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LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION {J.,ut-LJ-IJ ~11
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(Address) I~ ii"'..,4-tfLii ~ -d-v'&.
BUILDER (7 _ _
(Name) ~E-
(Contact Name)
(Address)
(Phone)
(Phone)
(Phone)
TYPE OF WORK
/'
0'New Construction
OPorch
ODeck
ORe-Roofing
o Fireplace
OAlteration
OAddition
o Misc.
OLower Level Finish
PROJECT COST/VALUE (excluding land) $
Date Rec' d
PERMIT NO.
OlflZ,Ol-
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~ING (office use)
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PID --'-S--.3;O-~?I-O
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.
I Permit Valuation
I Permit Fee $
I Plan Check Fee $
State Surcharge $
Penalty $
I Plumbing Permit Fee $
I Mechanical Permit Fee $
I Sewer & Water Permit Fee $
I Gas Fireplace Permit Fee $
r';~f~n ~omes Your Building Permit When Approved
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BuildiniOfficial Date
x
Signature
Contractor's License No.
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6."0
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Park Support Fee
SAC
Date
# $
# $
$
$
# $
# $
$
$
$ Q. () ( )
R.eceiPt;jJ. ~t7;.r:-
By /AX...
tI
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
is(!!z -yl '. f ^- P-L <_~ ~.... t e LPt/~ ~
~~ctor uate Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
"
Paid /1,- d l/
Date /()~~ (') I
'<'.,~
White - Building
Canary - Engineering
Pink - Planning
Thf Ctn'tr or Ihe I..kt Counlf}'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
/
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
,./
/--
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'./
/
Accepted
~
Accepted With Corrections
Denied
Reviewed By: ~~
Comments:
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Date:
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"The issuance or granting of a permit or approval of plans, specifications and
computations shall not be construed to be a permit for, or an approval of, any violation of
any of the provisions of this code or ofilny ~ther ordinance of the jurisdiction. Permits
presuming to give authority to violate or cancel the provisions of this code or other
ordinances of the jurisdiction shall not be valid."
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to corporation. owner and proprietor of the fallowing d" ,~''.eel property .Ituateel In the
~J::;rOF"~
The for~CJ $urw)'Ol"'. Cer\1flc:Gte WCI8 ockn
~NOB HILl. 2ND ADOf'OON.
loes hweby donate and dedicote to the public for public u.. for..- the trol. c:oun and cIrde,
0MIl only, And do h<<eby donate to the CIty of PrIor Lak~ ," . - ehown Oft the plat. In I hereby certify that , howe examined this pl.
JMd thae pr..."ts to be 8igned by Its proper officer th~doy o"~_ I"'. 1i~
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,:~ "..1'........ ..,~, ".,A.&....a.......~...t' '.........~..&,.l.. .......... "&."~. ."..~i.
i ..~ ;;..-",. CANDlCEL TRAU1'MAN
of '" '1ftIiI'~ NOTlII'Y PWIJC. _BtRA
We do her'e1 certIfr thet - ~..,
.... ., (
. .1.. .._,
PRIOR LAKE
INSPECTION RECORD
L/ '7 () , CD.1J'~ ~ I{,.( (s R-6/'~
NATURE OF WORK J...kJ /
USE OF BUILDING ~k ~~.p{~.er-
PERMIT NO. ~/- / /Q.?- DATE ISSUED 10-18..2t5t?/
CONTRACTOR . 'I ~ L.o1b. PHONE
NOTE: THIS IS NOT PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
.BUllDING AND INSPECTION
SITE ADDRESS
INSPECTOR
DATE
FOOTING I
, FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
fr;~
'II/1hz,
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
~
111 ?Io~
DO NOT OCCUPY UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card sha.i be placed near main entrance,
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
'I7tJ /
OWNER
PHONE NO.
o FOOTING
o FOUNDATION (f)
o FRAMING
o INSULATION
liI(FINAL
.fl SITE INSPECTION
DATE TIME
SCHEDULED tf !17!c'" ~ :r-.
~~~
CONTR.
PERMIT NO.
IJ I - / 2-0 2-
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 GASLlNE AIR TST
o
COMMENTS: jJo-J.. ~ '
(-'fl ~
~
~~
,
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
:,::,~ECT WO~: FOR REINS::::::FORE COVEmNG
,
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE..
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH de SAFETY!
INSNOTl
Lllal {.c,rri'OfCf~ Hlllj fJtvy
1/ .
CONTR. f.., './.." ~jJr(,&f Ltr ~
(
PERMIT NO. 6/"" /2& L
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~NAL
o SITE INSPECTION
COMMENTS:
(:"o~ - 12I~
SCHEDULED
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
DATE TIME
" -;U-oL
yt:EXI~ILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~RK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspecto~~
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
//VSNO TI