HomeMy WebLinkAboutBldg Permit 02-0315
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,16
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
+-4---"4;-
I. While File I PERMIT NO
2. Pink City . tJ 2 -, 03l Z!"
3. Vellow Applicant ...::>
(Please type or orint and siJill at b_~;,__)
ADDRESS 5798 Crossandra. Sired 5 f ZONING (ofliceuse)
PrlO"- U1kp. UI1JI 5537;)- pup
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
OWNER 1/ IJ M' 111,
(Name) nond ~ II/e:lta- 111:10r
(Address) 5198 G-05~ra... Sh-eef 5 e.
J
BUILDER C' j _ (l J . /) -r
(Name) . lCJn(ULL l.ilr1..SJ)'UC.1i11D {(1 ....LD'-
(Contact Name) lJJ"Jn"~ <;~f1dNU. _ J
(Address) a. 3010 East ~ I/VffJl.v~.. 5),~ko(Jf>p,
- I
TYPE OF WORK
o Misc.
PID25-z.9?- O(Jc,-O
(Phone) 952. - 22' - 5888
{f./or LEke III/IJ SS7,7-:J-
(Phone) 752.... '/().3 - q /00
(P{.~..~) !i;,,: Q.'i2 - t..J(J3 - 9{,00
55379
- .
/1111/
o New Construction
ODeck
OPorch
ORe-Roofing
OAlteration
.-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 loca1laws and will proceed in accordance with
submitted plans. I aw e 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 orm needed inspections.
x...
-----Signature
. Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
OLower Level Finish
o Fireplace
OAddition
PROJECT COST/VALUE (excluding land) S
'---
8c- 7:1.5/
Contractor's License No.
21 50 0 . 0 0
$ 74- 1~
$
$
$
$
$
$
$
I Park Support Fee
SAC
,..
Water Meter Size 5/8"; 1";
Pressure Reducer
I Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
lather
I TOTAL DUE
I.,j-V
TbBApp~BW4mgP;:~
Building Official Date
I Paid
I Date
i {, .(/(./
-1'-tf -(/ 7__
OLf -o5-o~
Date
# $
# $
$
$
# $
# $
$
$
$ 7~ ~d""'-
I ~
R=r~
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 '~"'lM.uy 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
"'T!..IJf~IQR VlKJ;
~~ NOTICE
SCHEDULED
DATE
L/ - 9-;;L..
~~C01
TIME
^""nJii~~
~'~t:)p
OWNER
CONTR.
PHONE NO.
PERMIT NO.
t>....2.- -"3 IS-
o FOOTING
o FOUNDA nON I
o FRAMING
o INSULAT~O ~
.J;P'iOINAL .' fI
o SITE INS EC ON
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAl
o EXlGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
.
~,:{~
".
~.
_,i_~
)( WORK SATISFACTORY, PROCEED
(0' CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ - _ Owner/Contr:
CALL 447-9850 ;~t;HE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH'" SAFETY!
INSNOTl