HomeMy WebLinkAboutBldg Permit 01-1116
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
(Please type or print and sign at bottom)
ADDRESS
3&75 /707]f
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
&%10
OWNER
(Name)
(Address)
BUILDE~ A 0>
(Name)-/!:::flf1<r L '/1'f tAL
(Contact Name) #iA.L ~ ,& 0+1' "tf-
~"/ .~"""~4\~ A-t-" J
(Address) :,/.~ " .'~""; - 6~(.. ./
# 1/ r 't---4-; A,/ C I /iJ AJ ~~" 1/
TYPE OF WORK
o Misc.
o New Construction
o Deck
I. White File
2. Pink City
J. Yellow Applicant
(Phone)
lo.e'DI
I PERMIT NO. 6/- III {,
III
zo.NING (office use)
/
,
I
)
I
PID 2.5-'1/0 - (}fJ~' o.
(Phone)
(Phone) 4- 'JJ -~ ? i/
OPorch
-
'f!-e-ROOfing
OAlteration
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
exnter upon th property?p perfOrm needed inspections.
l~ //).-?--tJ/
Signature Contractor's License No. Date
I Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
I Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
OLower Level Finish
o Fireplace
PROJECT COST IV ALUE (excluding land) $
OAddition
Z-/~,dV
$ '14-.1r
$
$
$
$
$
$
$
I.vr-
Tho Appli<atioo ~ p=it When App""'it
BH~ci~ D.'
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
I Other
I TOTAL DUE
Paid
Date
7(, .Cll.)
/t) -s--o !
# $
# $
$
$
# $
# $
$
$
$ 7~ .v()
1/1 II
ReceirIJW~J h fI &, -"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
DATE TIME
-f4hs-
ADDRESS
~?b75- /7CJ rL.
OWNER
CONTR.
PHONE NO.
PERMIT NO.
O/-///b
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~AL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EXIGRADIFILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLINE AIR TST
o
COMMENTS:
RefiJO ff) (~u:J~ ~
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~I .)
h- /~ ,/
~
~ORK SATISFACTORY, PROCEED
D' CORRECT ACTION AND PROCEED
REINSPECTION BEFORE COVERING
Inspector:
Owner/Contr:
CALL 447.9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOT/