HomeMy WebLinkAboutBuilding Permit 01-0705
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
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ADDRESS
LEGAL DESCRIPTION (office use only)
LOT hLOCK I ADDITION
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(Address) (--I
Date Rec' d
1_ White File
2 Pink City
J. Yellow Applicant
--7, '/;) -D /
0I~D70S-
ZONING (office use)
p t{ sf)
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(Phone) 0. '3;:S - .;);;).G Y
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BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
OPorch
o New Construction
o Misc.
~wer Level Finish
PROJECT COST IV ALUE (excluding land) $
ODeck
ORe-Roofing
ORe-Siding
OUtility Connection
o Fireplace
OAddition
DAlteration
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
enter upon the property t~erform needed inspections.
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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
$
$
$
$
$
$
$
$
ames Your
3
g Permit When Approved
~ 7_ :z"o (
Date
7 -I ey - 0 I
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 c'nll 1:'7) III Ci $ '11, . 2..s-
,
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Paid
Date
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
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While . Building
Canary . Engineering
Pink . Planning
-
Thr (-fntrr or lhf t.k.. Counlr)
BUILDING PERMIT APPLICATION DEPARTMENT CHECKLIST
.
NAME OF APPLICANT
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7- /~--() /
APPLICATION RECEIVED
The Building, Engineering, and Planning Departments have reviewed the building permit
application for construc&~ot~t~ Whi~::;;;:;: jJ
Accepted
Accepted With Correcttol,5
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//
D,";od ~ A
Reviewed By: ( /
Date: 7-r2~2aleJ1
Comments:
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"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
DEPARTMENT OF
PUILDING AND INSPECTION
SITE ADDRESS &.
NATURE OF WORK l..c<-<Ju- I~" 0 .\:;'" ..I~L-....
USE OF BUILDING S FA-
PERMIT NO. ~) DATE ISSUED
CONTRACTOR / PHONE ~3~ .J::t(~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
CORD
INSPECTOR
DATE
I FOOTING
I FOUNDATION (Prior to Backfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
SEWER I WATER I SEPTIC
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required)
FIREPLACE ~ 0(- '2--
GAS LINE AIR TEST
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
GRADING (Prior to Sodding)
BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT OCCUpy UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have, been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
,-----_.__.._----"-~-----,-_..._-_.__...._--,-----~---~---
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
DATE TIME
L{]/u/o, 9; po
,
ADDRESS
to;i'()? ~ p~
OWNER
CONTR.
PHONE NO,
PERMIT NO,
6/- 7()S
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
.~ FINAL
o SITE INSPECTION
COMMENTS: L, <-- ,
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINA
o MECH FINAL
o EXIGRAD1FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
"f;~
){JWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: ~ OwnerlContr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
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