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DATE TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE SCHEDULED ,yL
ADDRESS SI2-2 Wynb/}/~ Cf-
OWNER CONTR.
PHONE NO. PERMIT NO. 2 - ~t/
o FOOTING o PLUMBING RI o EX/GRAD/FILLING
o FOUNDATION o MECH RI o COMPLAINT
o FRAMING o WATER HOOKUP o FIREPLACE RI
o INSULATION t- L o SEWER HOOKUP o FIREPLACE FINAL
!FINAL r I o PLUMBING FINAL o GASLlNE AIR TST
SITE INSPECTION o MECH FINAL 0
COMMENTS:
LJ oSe 0-1-<
~WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT WORK, CALL FOR REINSPECTION BEFORE COVERING
Inspector: VV11 5" ~ },. - 0'7 Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
98-/,3 "I-f!
I. White File I PERMIT NO 'I
2. Pink City . 0.;,) - c-: ~
3. Yellow Applicant . ~.o _
ZONING (office use)
/2-/ SD
6- / 2 Z
1'1/yNDI1/lM eOUI.:'.-T .SE-
LEGAL DESCRIPTION (office use only)
LOT /5 BLOCK 3 ADDITION N/L-OEk:. Nc..$S l'tNL)S 2ND
PID 25-3:s8 - 034--0
OWNER,- ,J
(Name) ...>TE..\J E
C.
(Address) .) 1'2""2..
L. {Hf2..\STENSfA)
(h;~:N\,)HArt1 (0(.\/7_'1 5E
(Phone)
QS2 -22(. -llTl
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
ODeck
JgI Fireplace
OPorch
ORe-Roofing
ORe-Siding
'~ower Level Finish
o Addition
OAlteration
OUtility Connection
o Misc.
PROJECT COST /V ALUE (excluding land) $ ? 0 0 CO
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
ente~. the Pg;o rty tQ,[rf~. eeded inspections.
<-.- ( 0/'')-, 101
X ""'-. t1-l-,_........ ~ <.- <-I C <--
Signature Contractor's License No. Date
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
73
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1 "; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other ~/eL Perm,' +-- $ " -00
TOTAL DUE $ 1/7.25
Gas Fireplace Permit Fee
$
$
$
$
$
$
$
$
.of.
I 'So
4-0. -
proved
Paid
Date
~-!l;do~O~ I ~~ceiEt NrP q!S
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
16200 Eagle Creek Avenue Prior Lake, MN 55372
PRIOR LAKE
INSPECTION RECORD
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS 5 ( "22- W"( {\J oM-A"} C"
NATURE OF WORK L.. c. F'AJ IS H
USE OF BUILDING iLc~ A-1t2- / ,
PERMIT NO. 0 't- ~ S8<f DATE ISSUED ~ Iz-~;:" L
CONTRACTOR '5rcvhvCHtt.lsrGvy.::-N PHONE z-~ -("1'11
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
INSPECTOR
DATE
I~ I
I FOllJIDA II . r to-tiackfill) I I
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
FRAMING
INSULATION
ELECTRICAL
PLUMBING
HEATING (if required) 0
~~ ~ f'
A 1"2 - r - ., ~~ ,81 ~.L, ~
l'?v rz \ 6D r ?t' t-~-:. r ...li'-'\~ r r, t c-"t--'. ~c-v~, Pf 'b
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED (PI ?/~
I I I
FINALS
~~)
BUILDING '/11'}' .J S-/~U3
ELECTRICAL
PLUMBING W ~/L-
HEATING IZ{J 5'/1-
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