HomeMy WebLinkAboutBuilding 04-0378
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
/'-1 Q1y- (,)O-c
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
o FINAL
o SITE INSPECTION
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
COMMENTS:
DATE TIME
2').-?r~1(
PI C-/>
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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rORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
REINSPECTION BEFORE COVERING
Inspector:
t/7
Owner/Contr:
CALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
INSNOTI
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
Date Rec' d
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
at bottom)
(Please
ADDRESS
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LEGAL DESCRIPTION (office use only)
LOT:5 BLOCK J
~oA.Jf
ADDITION
OWNER
(N ame)
f\l\ df
(Address)
White
Pink
Yellow
File
City
Applicant
I PERMIT NO. 01-. 037~ I
ZONING (office use)
I!-IS J:)
,claAr
PID Zr. /q () . O()3 ~ 6
(Phone) 9 S ~ -q~t1.- ~0~
&if ~/d'-3~6-;;L ,;)...
3
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
OLower Level Finish
o Fireplace
TYPE OF WORK 0 New Construction
OAddition OAlter
eck OPorch o Re,Roofing ORe-Siding
ion OUtility ConnectIon 0 Mise,
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
I
E
II
F
I
III IV V A
HIM R
2 3 4 5
B
S U
PROJECT COST /V ALUE $
(excluding land)
I hereby certify that I have hlrmshed mt()rmation on this application which is to the best of my knowledge true and correct. I also certify that I am the owner or autho!'lzed agent for the
above-mcntlOncd property and that all constructIon will conform to all eXlstmg state and local laws and will proceed in accordance with submitted plans I am aware that thc buildmg
otliciaI can revoke thl er it for Just ca Furthermore,l.('er y agree that the CIty official or a designee may enter upon the propetty to perform needed mspecllons.
x
Permit Valuation I{ C)(){)O. eO
Permit Fee $ 8B.25
Plan Check Fee $ S? '3G,
State Surcharge $ '.5"0
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
This Application Becomes Your Building Pennit When Approved
~ f,;JJ~
Build1l1l! Otllcial
o/L(~'f
Date
Contractor's License No,
<I::) (j ~ ey
Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; I"; $
Pressure Reducer $
Sewer/Water Connection Fee # $
Water Tower Fee # $
Builder's Deposit $
Other $
TOTAL DUE J1 JiIIA A VY) r.4--. OJ- $ /1/7. II
Paid
Date
/ ~1: r -() 'I I ~;"i~ I/t,&- /II
ThiS IS to certify that the request in the above application and accompanymg documents is in accordance with the City Zoning Ordinance and may proceed as requested. ThIS document
when signed by the City Planner conslltutes a temporary Certificate of Zonmg compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
Special Conditions, if any
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372
'/
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PRIOR LAKE DEPARTMENT OF
BUILDING AND INSPECTION
INSPECTION -
RECORD .
SITE ADDRESS I t/ if'~ PIXIE j/J",i.Jr- C,MLE"
TYPEOFWORK Nt;w D~IL 12'Xlo' ,.yFi&TUA. ~1ItJH 1}estG~
USE OF BUILDING S.F; D ,
PERMIT NO. {)(OJ7eJ DATE ISSUED S/"I/oct
BUILDER ~U6 ZiLA PHONE~.~l.""-ZS7Z.
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELOW
THE PERMIT IS BY SEPARATE DOCUMENT
FUru IU. tot 1)es.IG,NE~ fOe,.... SNsPECTOA
FOOTING
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN
- I I
lRNAL I I
FOR ~ALL INSPECTIONS (952) 447-9850
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