HomeMy WebLinkAboutROOFING 07-1031
ADDRESS 3'{ '1 L,
DATE
SCHEDULED ~~
W;l~~J
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
PHONE NO.
CONTR.
PERMIT NO. ....., -- J IJ :> /
OWNER
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
.;KH=INAL 0 PLUMBING FINAL
o SITE INSPECTION () 7'MECH FINAL
COMMENTS: (K'2Tt"J);--
o EXIGRAD1FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
. I'" "-
~\6se.~ 7~
. lJe llo,J fL.,. rJ>\
o WORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
;f.. CORREC"'O~~LL FOR REINSPECTION BEFORE COVERING
Inspector: (\I \\- ) OwnerlContr:
~ALL ~-~OR 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
1 While
Pink
Yellow
File
City
Applicant
PERMIT NO. 01/03 /
(Please type or print and si~n at bottom)
ADDRESS
:5' c;4-~?
f;v /f..,.c{;lv
C e-/t r.w-t
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LEGAL DESCRIPTION (office use only)
LOT
ADDITION
BLOCK
OWNER
(Name)
(Phone)
(Address)
BUILDER /1..a-
(Company Name) /7 / E ?<.
(Contact Name) A/4/< C p;j
(Address) I l 00/ ..{:,:J 1x'.E tJ ~ ~
(Phone)
(Phone)
;2. c/
PID
Date Rec' d
10. z_s. 07
ZONING (office use)
7~3-'f~c//~€/ RCj
~ /;; . -3 ~ ft. .J~r ~ 3-
TYPE OF WORK 0 New Construction ODeck OPorch ;V~e-ROOfing ORe-Siding OLower Level FinIsh 0 Fireplace
OAddltlOn OAlteration OUtility Conne~
CODE: OI.R.C. OI.B.C. o Mise
Type of Constmction: I II III IV V A B PROJECT COST IV ALUE $
Occupancy Group: A B E F H I M R S U (excluding land)
Division: I / 2 3 4 5
I hereby certity that I have turnIshed mformatJOn on this applicatllln which lS to the best of my knowledge true and correct. I also certify that I am the owner or authof!zed agent t\lf the
above mcnttnncd ptopelt nt all (onstluctlOn wIll contOlm to allCxlstmg state and local laws and wIll plocccd In accOldancl' WIth submItted plans I am dWdH.' that the hUIldmg
~IiClal can revoke tlm I I mlt tor IJ.i'e;t).. ' "elcby agree that the City otfiClal"r a deSignee may enter upon the plllpeny to pel torm needed 1/0/02 .!!.~ 1'07
Signature Contractor's LlCense No Date (
Permit Valuation
Permit Fee $
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
I
Sewer & Water Permit Fee 1 $
Gas Fireplace Permit Fee I $
Park Support Fee
SAC
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer IW ater ConnectIOn Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
/b ..~'
/0.. 7r~{)- /
I
Paid
Date
Iluildlllg Ulrlclal
Date
#
#
#
#
()
R.tkeipt No.
Bf /.
J
$
$
$
$
$
$
$
$
$
-lC:, - (j"U
!/1 t(c7 U
This IS to certify that the request 1Il the above applicatlOn and JccompanYll1g documents 1$ 111 accordance With the City Zoning Ordinance and may proceed as requested Thls document
v,'hcn signed by the City Planner consututes J temporary Ccruticatc of Zuning compltancl' and allows construction to commence Before occupancy, a Certificate llf Occupancy must be
i"ssIIcd
Planning Director
Date
24 hOllr notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any