HomeMy WebLinkAboutBuilding Permit 03-0141
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
PERMIT NO. tJ 3-- ILl /
(Please type or priflt and sign. at bULLu",)
ADDRESS
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ZONING (office use)
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LEGAL DESCRIPTION (office use only)
LOT rJBLOCK (ADDITION
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OWNER
(Name)
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(Phone)
(Address)
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BUILDER \ M
(Name) "'\ 0 vY\
(Contact Name) ,,~ ra.....(
(Address)
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(Phone)
(Phone) (0 I C.
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SCS'I
TYPE OF WORK
o New Construction
DDeck
OPorch
ORe-Roofing
ORe-Siding
OUtility Connection
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o (J~.
~ower Level Finish
o Misc.,;l.. ~
o Fireplace
OAddition
OAlteration
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PROJECT COST IV ALUE (excluding land) S
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 tOjerform needed inspections.
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Signature Contractor's License No. Date
I Permit Valuation 2ot:Jo. () 0 I Park Support Fee # $
I Permit Fee $ "2. z...C; I SAC # $
I Plan Check Fee $ I Water Meter Size 5/8"; 1"; $
State Surcharge $ Loa I Pressure Reducer $
Penalty $ I City SAC and WAC # $
Plumbing Permit Fee $ 1..(0,00 I Water Tower Fee # $
Mechanical Permit Fee $ I Builder's Deposit $
I Sewer & Water Permit Fee $ I Other $ /1
I Gas Fireplace Permit Fee $ I TOTAL DUE $ / lJ 3~ d--';J 1
, .- 7 .--.~
This Application Becomes Your Building Permit When Approved I Paid $. It) ~.~:::J Receipt No. l..{ ~' , Iv
~ ~ c:;/~/o:! I Date d-I...J-~ By ('r ---
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Building Official 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
is~~
Planning Director
a;~; Special Conditions, if any
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
- T -T
PRIOR LAKE
INSPECTION RECORD
SITE ADDRESS ~G ()L(- /50 l~ 5--f
NATURE OF WORK fr If e ~c( + /o~ .- L L
USE OF BUILDING . C; F
PERMIT NO. n -~- I L/ / _ DATE ISSUED :J - '1--3 .
CONTRACTOR fl1(J-nt U~ , PHONE&/~-.J39- P:J--s-j
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTOR
DATE
1- " I
_rior to Backfill) I I J
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
-
FRAMING VW~ }.. -f()-t[3
INSULATION t/l{/ ~..,(t>-~
ELECTRICAL
PLUMBING M/ J.,-/(}-03
HEATING (if required) f'Vy? 'J-r11J'" d?
I
--
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
~
~
I ~Ac-
UNTIL ABOVE HAS
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.
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BUILDING
ELECTRICAL
PLUMBING
HEATING
DO NOT
~
OCCUpy
I
BEEN
~lt'{pie3
f.i J (p /lI'&
SIGNED
Call between 8:00 and 9:00 A.M. for all inspections
FOR ALL INSPECTIONS (952) 447-9850
In
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CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION i J /
')!. FINAL (....A./
o SITE INSPECTION
COMMENTS:
DATE TIME
s ro ()Lf
!I,/tJ-3
/& tJ'V--U
SCHEDULED
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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II r: e,.
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o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT ~ IA~R REINSPECTION BEFORE COVERING
Inspector: ~ Owner/Contr:
I
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
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