HomeMy WebLinkAboutBuilding 05-0980
DATE TIME
CITY OF PRIOR LAKE ~ /,.. I
INSPECTION NOTICE SCHEDULED ~I t1~
ADDRESS J{,l/}O (;.. LlL'~ J4v.e.. Sf
OWNER
CONTR.
PHONE NO.
PERMIT NO.
s- - ~8)
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
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
COMMENTS:
_I 1/\ -"l
e'~ '-. tn
. \
o WORK SATISFACTORY. PROCEED
o CORRECT ~~N AND PROCEED
o CORRECr~ CALL FOR REINSPECTION BEFORE COVERING
Inspector: , (J' / / Owner/Contr:
CALL ~~ FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
INSNOTI
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
10 . $. ~S-
I White
Pink
3 Yellow
File
City
Applicant
PERMIT NO, ~S. ot8t} .?
(Phone) (ef/.$'?;)~' ,- 1'0";1
f1'h,_k/~~Atv ~S77L
(Please type or print and sign at bottom)
ADDRESS
i(,(,}O ;:;/I.,-.ll).'\ -r;.. SE 5:;.k /2() C
LEGAL DESCRIPTION (office use only)
/ I/U, "1. (
Sr~'
/iA)J' t JdL) ~ (!,;)Ud /06DpID
~ ~
LOT
BLOCK
ADDITION
OWNER
(Name) ;).vi? 'Z/lIkG
J.-'~"'J..) "V. ii' L L ~-
(Address) I(..;C-/L) 1-;3-'/."'''.17-_ .ft;' 5:';..k1:2" C.
BUILDER
(Company NameL.LJ/;..) Uh. f::1~ J';J;:,. '-
(Contact Name) JvJG';") tk."ul,
(Address) 16{,7D f7.tt.,k./:',,-r;... -5l;; ~~; k /20 C-
ZONING (office use)
111-oo~-o
(Phone) ("9j-Z) S'~() --l,'l.j
(Phone) (f6 2) 291-- 7Jl~j'-
PL lAW JJ.-/ 1'L
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing
OAddition ~Iteration OUtility ConnectIOn
ORe-Siding
OLower Level Finish
o Fireplace
CODE:WLR.C. OLB.C.
Type of ~nstmction:
Occupancy Group: A B
Division:
o Misc. kM)V~ t:"~JJ./'''t~ h.)i,Mi, WiJ~ "'Rio, h;Jdl
E*I ~r..,3 ')tJ' 1~/'trJ on tE?KIr-~ .
PROJECT COST IV ALUE $ ~ ID
(eXcludingland)~~/O _ -;.~ ~'1!)f
V
V
M
4
A
R
5
B
S U
I
E
II
F
1
III IV
H I
2 3
I hereby certifY that I have hi cd mformation on this application which IS to the best of my knowledge true and correct. I also certify that I am the ownn or authorized agent for the
above.mentlOned pro I' an hat all Cllnstruction will conform 10 all eXIsting state and local laws and will proceed in aCCllrdance with submItted plans. I am aware that the building
Ilftlcial can re er I for Just cause Furthermore, I hereby agree that the City offiCial or a deSIgnee may enter upon the property to perform needed InSpectHlns
. - --- 7t:J~z)/Zlt/'I ....?/Ap~ 0;)-
x~
// /
Contractor's License No.
/
Signature
Permit Valuation ~60{),-
Permit Fee $ 7'1,75
Plan Check Fee $
State Surcharge $ 'If l ' 'Z.s
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
I Park Support Fee
I SAC
I
#
#
Water Meter Size 5/8"; 1";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
~B<<~~Wng;;;;;;Pro"d
l3uildll1g Official f 'Date
Paid 7(,. tV
Date IO.3"O~
Date
$
$
$
$
$
$
$
$
$
76, tJo
500&5
II
rlNO
ThiS IS to certify that the request in the above applicatlon and accompanymg 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 Zonmg complIancc and allows constructIon to commence. Before occupancy, a CcrtItleate of Occupancy must be
issucp " \/ ;-" '. c-J.;>f I, c- A ~~. ~. " ~ ..J7~L .~
_~ ~ ?flj ItJ--- :r '. 'f-6r:,.~tJ.) dl~-b>.~,.
Plaiming Director Date'--' ,~ecial Conditions, if any J
24 hour notice for all inspections (952) 447-985 ax (952) 447-4245
16200 Eagle Creek Avenue Prior Lake, MN 55372