HomeMy WebLinkAboutBldg Permit 01-0382
(Please type or print and si2Il at bottom)
ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I. White File
2. Pink City
3. Yellow Applicant
/S5Q 0
J!t'&Ht-,4-AJjJ Ave iV .w_
LEGAL DESCRIPTION (office use only)
LOT -0 BLOCK a. ADDITION J)Af~
LJ mAl / ~J-
~~e~R N\ ~ ~ ~ ~1\.Arz a AtJtJ& ~AJ
(Address) \ SS-Cf 0 4~~~ Aij) ~ A.J r(0
~~;~~R~-plu4i~r C~m-~~f}$-
~ ~ ~Wf--
~LE cr~L Q~
(Contact Name)
(Address) '8 <f~ "-0
TYPE OF WORK
o Misc.
(Phone)
PID.Q5" /'-13' 0 .J.J-D
~PhOne)t{S 7- --'2-'3 3 .-l!f3 R-o
(Phone)
o New Construction
~
cnre:Roofing
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 ention pro and that all construction will conform to all existing state and local laws and will proceed in accordance with
,,,,,",,tt<d pl=. I ~ 'WM t "" il. g ffici>l om re,olre lbi' p<nnit fot jmt mmo. Furth=ore. I hereby """ foot foo ii~cif a designee may
enter upon the property t rfi ne e ns ctions.
X . \ v ~/{,g<?S3' / tit
Signature ContraCtor's License No. Date
I Permit Valuation
I Permit Fee
I Plan Check Fee
I State Surcharge
I Penalty
I Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
ODeck
OPorch
OLower Level Finish
o Fireplace
OAlteration
OAddition
PROJECTCOST/VALUE (exc1udingland) $
d~~tJr -- .;
$ 7L/. /5
$
$ / r ;)S'
$
$
$
$
$
I Park Support Fee
I SAC
I Water Meter Size 5/8"; I";
I Pressure Reducer
I Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
1/<1. ou
5~/-n J
Building Official
Date
#
#
#
#
$
$
$
$
$
$
$
$
$ *'1fJ?,0lJ
Receipt No. 3q53~
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
ADDRESS
155-10
SCHEDULED 6 /' d.-/-o /1'; 3Q
. H ~qh/c2~
CONTR.
OWNER
PHONE NO.
PERMIT NO.
1- ~~~
-
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
I\... ~FINAL
n 0 SITE INSPECTION
COMMENTS: R t:JC,,p
...
dLruId)A~
o PLUMBING RI 0 EX/GRAD/FILLING
o MECH RI 0 COMPLAINT
o WATER HOOKUP 0 FIREPLACE RI
o SEWER HOOKUP 0 FIREPLACE FINAL
o PLUMBING FINAL 0 GASLlNE AIR TST
o MECH FINAL 0
-~f-
---- ,,-
fe./
l
'--
~/
~-
/
~ORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o COR~RK\~L~FOR REINSPECTION BEFORE COVERING
Inspector: ~ .....\.#,1A Owner/Contr:
CALL ~7-9850 FOR THE ~EXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl