HomeMy WebLinkAboutBldg Permit 01-1252
CITY OF PRIOR LAKE BUILDING PERMIT, Date Rec'd
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT /()- 3? .~ /
I. White File
2. Pink City
3. Yellow Applicant
(Please type or print and sign at bottom)
ADDRESS
14v1..1 e,1 utbl V- d Tv-a. ,I N&
LEGAL DESCRIPTION (office use only)
LOT BLOCK ADDITION
OWNER
(Name) ja ~ t>h \t.Db I AS.
(Address) 141.P'2.1 ts\\A.tbi\-'-tl IVai \ Nt
. (Phone)
BUILDER
(Name) ~Y)n1'V Cxvt~f.+tfiY\ ) InL.
(Contact Name) ~II \ aaV4bh.->
(Address) \ c;b{P~ Q,V1 tl~ e,w it it V t:i.r .
TYPE OF WORK
o Misc.
(Phone)
(Phone)
So Vtltlu
~w Construction
o Lower Level Finish
~
o Fireplace
OPorch
ORe-Roofing
PID
QS2.- 4'll.1 - 2f:);,.,2-
~_..__.-
qt;; 2- - 44D -11f,D
'I CDC
ORe-Siding
OUtiIity 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 wilI conform to all existing state and local laws and wilI 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 1I-a-vtL- t1 V\.5~ l.D "l..llP II 0 \0 I ~ 0 \ () I
Signature Contractor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
OAddition
OAlteration
$
$
$
$
$
$
$
$
$ /38.eto
Receipt No. 'IrJI'I1
fP~
#
#
#
#
II~ 1-0/
By
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
PROJECT COST IV ALUE (excluding land) S
$
$
$
$
$
$
$
$
3.000.00
83.2~
54. ( I
l.sO
I Park Support Fee
I SAC
I WaterMeter Size 5/8"; 1";
I Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE CALLED
our Building Permit When Approved
I Paid
I Date
'$' /3f, ~0
11- ;:;"/ -0 I
ID -30''2.co(
Date
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
The ('enlt'r or Ihe t.kt Counlf)-'
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
APPLICATION RECEIVED
+)~;c., (~(~
ItJ ,'" 30 -() I
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
Itl& /9) U~k~u~~._1/v)
Accepted
Accepted With Corrections
y
Denied
Reviewed ByQ...o, g+
Date:
!f>-~O-~(
Comments:
~ ~~ V\.a-r~~
"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."
-t.
PRIOR LAKE
INSPECTION
RECORD
SITE ADDRESS )4lo;(\ - ~~r& \ra.i\
TYPE OF WORK ~~
USE OF BUILDING 0~D
PERMIT NO. (J/- /Z52- DATE ISSUED ID -:,0- 200/
BUILDER hnntier ~J-# b.t! PHONE #~~-4~o -7?,~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INS~ECTOR
DATE
FOOTING I [Yr, I /2//)//)/
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
J~ I I
I FI NAL
/"7
~
I jz//4/t?/
/
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
a/lift, A. (.
/St~ j-,e,
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/'I~z/
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
'ilf FINAL
(0'" SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:~~
-
f11l<nu
. ..JI' .
,~
.
-~-
........,
I t'"
/JC00
(
~
DATE TIME
tJ I - /252-
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
f(lWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~, Owner/Contr:
CALL 447-9850 F~ ;HE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!