HomeMy WebLinkAboutBldg Permit 01-1265
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERIU'lCATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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PUC (~~~
-1lf050
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1. White File
2. Pink City
3 . Yellow Applicant
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LEGAL DESCRu- lION (office use only) ,
LOT q BLOCK~ ADDITION ffrlUtPtt ~
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(Name)
(Address)
bA'\J i }) T R.l N J.J-
~mp
BUILDER
(Name)
(Contact Name)
(Address)
TYPE OF WORK
o Misc.
~
o New Construction
OLower Level Finish
Date Rec' d
PID ;))r7;t-13- C(&-r)
~,,9];;< '/03 -- 6109
(Phone)
(Phone)
~Deck
OPorch
ORe-Roofing
PROJECT COST IV ALUE (excluding land) S
o Fireplace
OAddition
OAlteration
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 prop and that all construction will conform to all existing state and local laws and will proceed in accordance with
submitted pia m are buildin cial can revoke this permit for just cause. Furthermore, I hereby agree that the city official or a designee may
;",upo .pro. mp di ~ T -- C_, Lio>u<No /I ~_~ ;/;,0 0 }
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
Plumbing Permit Fee
Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
r::..-"
3 00C, DJJ....
$ fJ3,~!;"
$ 51,/,. / ~
$ l ~ 5U
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
~~
Building Official
/1/5/11
,
Date
I Park Support Fee
I SAC
I WaterMeter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
.A1 r; 0 I
I Paid-4 /~.A; X I~)O
I Date 0 J 1-5- I
# $
# $
$
$
# $
# $
$
$
$/~R/'&O
Receipt No. i..;Ju' 1./ 1/
BV~'
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 tor all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
Thf ('fnler of lhf tlkf Counlry
White - Building
Canary - Engineering
Pink - Planning
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
NAME OF APPLICANT
f) lMJ;d rr~ Art+-
/ I--,y-O J
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construction activity which is proposed at:
I iff);o ~~ '- )/L- /U e..J
Accepted
Accepted With Corrections ';L
Denied
Reviewed By:
Comments:
~~
~~~~
Date:
///5/0/
I
"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
/J -
SITE ADDRESS 1~~tlLJ(J ,(1t~//flf!M/~ ~
TYPE OF WORK DeL I{
USE OF BUILDING .<1=
PERMIT NO. t? 1- / ::J.ld 5" DATE ISSUED /I-S-O)
BUILDER J]'LU 1- c/. Ir / IV h PHONE Ifis.J-ijIJ3- b301
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR DATE
t FOOTING LO(e I ~ IJ..t1./~' I ~.f,;l'~~"
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
_____ I I ,
'FINAL (<::j~ fJertm/f-.# OJ--t 9:+[; J
-
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
ADDRESS
IC/oso
7_.;:E _ n,E
SCHEDULED CJu ~
g /u-cb/rd I.r
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
~INSULATIO ~. _ _ V
FINAL '-e.J-f-
SITE INSpJTlON
COMMENTS:
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
,5ee- ;VOfc.s i IV If, r eSS
See- perl11d--d:- Od- 90t
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
..e1 WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSlVOTI