HomeMy WebLinkAboutBldg Permit 02-0577
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sism at b~...u~)
. ADDRESS
02LtO 150+h
s+.
L White File
2. Pink City
3. Yenow Applicant
Date Rec' 41
..
PERMIT NO~~ - S- //7
C;;E-
LOT
BLOCK
LEGAL DESCRu- uON (office use only)
ADDITION "JA ..I'U;:t7Z!
4t5
OWNER
(Name)
I( enn e.,fh St, I ( s
f.o~40 160+" sf. Sf...
(Address)
BUILDER D A__ _ . _ (
(Name) r\ trOD ~ f'HYll/l t (CA
(Contact Name) ~S~
(Address) q ScfJ Uftddt ftv..t
TYPE OF WORK
o Misc,
f?iSi)ceuse>
PI~ J;;J.. 3- OY/-(.)
(phone) Q5J.. - 447- 5070
e~ . (Phone)
(Phone)
~{h .13(ODml~cahvv fvtN
o New Construction
DDeck
~e-Roofing
t} S-,,2- Pf ( -(
554.20
DLower Level Finish
o Fireplace OAddition DAlteration
PROJECTCOSTIVALUE (excluding land) $ 5. t.tDO
,
o Porch
ORe-Siding
OUti1ity 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
;ter upon the rJ . .fJrm needed inspections. dOlt.( I Lf (0 S- /~ I ~ 2.
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
d ~d)-,---
$ "1t/, ,5-
$
$ )<J.5
$
$
$
$
$
This Application Becomes Your Building Permit When Approved
Building Official
Date
Contractor's License No.
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
rPffr14, .S(l
I Date .5- ;::rd... - h7..
#
#
#
#
Date
$
$
$
$
$
$
$
$
-'"
$ 'lb~u.>t-
ReceiPt No. LI;)"o ~j
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
Date Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
(;, . ~c/. fI'Z. Pl. T,
&Z4-0 /5?)-n-f ..s' /
SCHEDULED
ADDRESS
OWNER
CONTR.
PHONE NO.
PERMIT NO.
Oz.,-O~77
o FOOTING
o FOUNDATION
o FRAMING
&INSULATION
~ FINAL ,e4!;
o SITE INSPECTIO
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
~~
P!WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ /7 Owner/Contr:
CALL 447-98; ~1R THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl