HomeMy WebLinkAboutBuilding 02-1518
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
~ V;;i~
~co
TIME
OWNER :----- CONTR. _ ~
PHONE NO. - _ PERAfITNO. ~
o FOOTING 0 PLUMBING RJ 0 ExJGRADlplLlING
o FOUNDATION 0 MECH RJ 0 COMPUINT
o FRAMING 0 WATER HOOKUP 0 F'''''PUCE RI
o INSUUTlDN 0 SEwER HOOKUP 0 FI""PUCE FINAL
o FINAL 0 PLUMBING FINAL 0 GASL'NE AIR TST
o SITE INSPECTION 0 MECH FINAL 0 __
COMMENTS:
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o WORK SA TlSFACTORY. PROCEED
o CORRECT~N AND PROCEED
o CDRRECi WOrul~ALL FOR RElNSpECTlON BEFORE COVERING
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10'PedOC ~ Owne,tCoO.' ~
fMJ.. '147'.8.0 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQU/lIEMENTs AIlE FOR YOUR PERsONA/. HEALTH.. "'FErrl
lNSNOTJ
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
(Please type or print and sign at bottom)
ADDRESS
~. ~i~i~e ~::y I PERMIT NO. AI_Ie-I,<;:Y"
3. Yellow Applicant L/~ ...J I,~
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~UCLL.m{)r( _
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LEGAL DESCRIPTION (office use only)
LOT fh,LOCK ADDITION ~/--r~d\'~~
O~ER
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(Address)
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tlUILDER
(~e)
(~tact Name)
(~s)
.r}(CL;\(/ (L1C
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(1Pbone)
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(Phbne)
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TYPE OF WORK
~Roofing
DAlteration
ODeck
o Porch
o New Construction
OLower Level Finish
o Fireplace
OAddition
o Misc.
PROJECT COST IV ALUE (excluding land) $
ZONING (office use)
PIDc7,- tJ 91':' 01/-0
tj '/ 7 -
9' 7 f'V'
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ORe-Siding
DUtility 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
enter upon the prope1}Y to perform neede,~spections.
xJ)!I..WiY, r)(.i/(,. t-:J ~" ,>,( C' ,~3 -) L..J I) /) /. ( j
~e ~\~j;ceonttactor's License No. Date
I Permit Valuation ~50(), - I Park Support Fee
I Permit Fee $ 74t 7S- I SAC
I Plan Check Fee $ I Water Meter Size 5/8"; 1";
I State Surcharge $ I.;}- ~ I Pressure Reducer
I Penalty $ I City SAC and WAC
I Plumbing Permit Fee $ I Water Tower Fee
Mechanical Permit Fee $ I Builder's Deposit
Sewer & Water Permit Fee $ I Other
Gas Fireplace Permit Fee $ I TOTAL DUE
This Application Becomes Your Building Permit When Approved
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Paid
Date
Building Official
Date
# $
# $
$
$
# $
# $
$
$
$7 G /----
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Receipt No.4 ~ 7;;
By tjC/
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