HomeMy WebLinkAboutBldg Permit 01-1251
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File
2. Pink City
3, Yellow Applicant
PERMIT NO.
NING (office use)
'K'
(Please type or print and sign. at bottom)
ADDRESS
5uYo"os- /)-c.~c..f-,~/j {':;J1C S.E'.
LEGAL DESCRIPTION (offic~ use only), .
/ 7 / /)all'h-e!cI ..;J,..,d
LOT BLOCK ADDITION
PID (;(5-37d.-- 0/7-0
OWNER
(Name)
(Phone)
(Address)
BUILDER.
(Name) 'D. 12. f-!z'V/.,.1 . ::;::;".C-. /)1d
(Contact Name) l11u...J-<..)I, t-.l,,1 ~...
(Address) 010 1;"0 /<e",h'ld~ (.'~'V' I- sic.
(Phone)
(Phone)
Lp. fa /II lIe, /11/./ S3lJ:lV
95.....'- 9,)7..5-' 71'i'j,
/ (.Ii)
,
TYPE OF WORK
o New Construction
~ower Level Finish
DDeck
OPorch
ORe-Roofing
ORe-Siding
OUtility Connection
o Fireplace
DAddition
OAlteration
o Misc.
PROJECT COST/VALUE (excluding land) $ ,;2 J 7/.; {}
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.
X Yk;LL"t i~~1LL~
" Signature
o?,;O().:::.~5-7
Contractor's License No.
/ v -..:l.S--()/
Date
I Permit Valuation "" (lr')t") . If!) CI I Park Support Fee # $
I Permit Fee $ '4. 1 S- I SAC # $
I Plan Check Fee $ I Water Meter Size 5/8"; 1"; $
I State Surcharge $ I,SO I Pressure Reducer $
I Penalty $ I Sewer/Water Connection Fee # $
I Plumbing Permit Fee $ qo,o cJ I Water Tower Fee # $
I Mechanical Permit Fee $ I Builder's Deposit $
I Sewer & Water Permit Fee $ I Other $ ]
I Gas Fireplace Permit Fee $ I TOTAL DUE $//&;. zs- I
) /J I J' (d S/
his Ap .;:;t YO.,Boildiog P~t Wh~ APPID"d I Paid Receipt No.l.j()0 L~ I
1 II'}_,,-, -coo { I Date ~.~.-(JJ By J('/' I
cial Date
This is to certify that the request in the above application and accompanying documents is in accordance with the City Zoning Ordinance and may proceed as requested. This document
when signed by the City Planner constitutes a temporary Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Planning Director
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
~~
White - Building
Canary - Engineering
Pink - Planning
The ('rnter or Ihe take Counlr}'
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT )) l? jJ () r~t_J:j ~
APPLICATION RECEIVED 10 -3cY-O I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activ~tYf, hich is p~op~?ed at: .
5CioS- ~-=f!cP La/)l<' /
(
Accepted
Accepted With Corrections X
Denied
7$(
l
~~r:~J~
~ ,
Date: JCJ-~-~
Reviewed
Comments:
~~
"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 of any other 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."
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
B.UILDING AND INSPECTION
SITE ADDRESS 5d..(}~- n.aqJ~-e.1.d2
NATURE OF WORK ~~~I'-~
USE OF BUILDING c::::.W
PERMIT NO. (J/-/2.&)/ DATEISSUED /O-X::J.~/'
CONTRACTOR tJ(~~ PHONE 7s"::?-L'}e.'5"'-7r~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I
I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
/I . )
.V
· A f/ /fl{/J
' ~ ,7 / ' "vi Uj 0 "7-' 'V
Y ^ JV I ./ .
! /rll~ ~ ~l) I
,I
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
BUILDING
ELECTRICAL
PLUMBING
HEATING
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 sh.al! be p.laced near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850