HomeMy WebLinkAboutBldg Permit 01-1115
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ADDRESS
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
/bZ/5 WGS-7
~.
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
OWNER
(Name)
(Address)
I. White File
2. Pink City
3. Yellow Applicant
ADDITION
At?~ O~
;'-./- ,-
BUILDER .~
(Name) ~7pr jrtA.L
(ContactNanIe)~L ~ ~u-+; V1 t
(Address) 7()<-!)S,,-;),.L/ ,~.;UJ ~ -~L; /
'blip: ,'LA:vc!"/ If} v =~O/I
TYPE OF WORK
o Misc.
o New Construction
OLower Level Finish
. (Phone)
Date Rec'd
10 ~8-o I
I PERMIT NO. ~ 0/ /5
tNTNG(_=l
PID 25-Qo2..- 1"lA-- CL
(Phone)
(Phone) 4 7~j. -~ q Ii
ODeck
'1JRe- Roofing
6~lteration
PROJECT COST /V ALUE (excluding land) $
o Fireplace
o Porch
OAddition
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-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 ~n the ~r~PJfY to perform needed inspections.
x~p~ 10.-1- 0/
Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
$
'l-,.$ () l) . aV
. '7t/.1 r
I $
1$
I $
I $
I $
1$
I $
...
I . '2.-r
"'" App~~ Y= B.......g P=>it Whro """,",,'
Building Official Date
I Park Support Fee
I SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
I Water Tower Fee
I Builder's Deposit
I Other
I TOTAL DUE
I Paid
I Date
,
/fl:I~ () 0
, ({J...::..I. D J
# I $
# is
I $
I $
# I $
# I $
I $
IS
I $ 7'.P"V
Reij/1- 10(. t. 7
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
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
16Y.15 w~sf
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
piNAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBlpG INAL
./f MECH FIN
/Le/(/O
COMMENTS:
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DATE TIME
~/~-
61- ///5-
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
YWORK SATISFACTORY. PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK'"c;~L W ~EINSPECTION BEFORE COVERING
Inspector: f/ IZ/ r Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTl
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!