HomeMy WebLinkAboutBuilding Permit 01-0056
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Please e or rint and si
ADDRESS
LEGAL DESCRIPTION (office use only)
Date Rec'd
I, White
2. Pink
3, Yellow
File
City
Applicant
LOT
'"
PlD
BLOCK
ADDITION
OWNER
(Name)
J.~IC€
(Address)
(Phone) WfJ - '/(,..7 S-
I 'UITDER
(Name)
(Address)
;t}.wAl;;~
(Phone)
TYPE OF WORK
o New Construction
ODeck
ORe-Siding
OLower Level Finish
o Fireplace
o Misc.
OPorch
ORe-Roofing
[}31Jteration
OUtility Connection
OAddition
//\{)Q <70
PROJECT COST/VALUE (excluding land) $ / U
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 local1aws 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 prop;:rty to perform needed inspections.
x
$
$
$
$
$
$
$
$
" ~O
Signature
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
/- ~-Ol
Date
Contractor's License No.
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1'" $
,
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE $ .SO
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 consnuction 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
..
PRIOR LAKE
INSPECTION
RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
TYPE OF WORK
USE OF BUILDING
PERMIT NO. D l- S{p DATE ISSUED
BUILDER c IT'"\" 0 F ~oe !-AILe"
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
llQJ ::\ AO~L-fV\~r-J
REM 00 e:c.-
\/31 10 I
INSPECTOR
DATE
~ I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
I FRAMING I I
I fJ1 P I (d-(,-O~
.
I FINAL
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS 447-9850
---.....--'---'-"'-'-"-''''-'''--'''-''--'''-'
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
/7073
OWNER
SCHEDULED
Ir-fHr 141 avJ
.
CONTR.
PERMIT NO.
Of -():)~c.
PHONE NO.
o FOOTING
o FOUNDA nON
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
COMMENTS:
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL ~
Oddr
DATE TIME
(;-(,.
~-r
-
o EXlGRADIFILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
&l() S G
~l-'
IjtWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: (}r? /~-&- O~ Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY/
lNSNOTl