HomeMy WebLinkAboutROOFING 08-0585
CITY OF PRIOR LAKE
INSPECTION NOTICE
SCHEDULED
ADDRESS
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OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
-g'FINAL 0 PLUMBING FINAL
o SITE INSPECTIOfl 0 MECH FINAL
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DATE
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TIME
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o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
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YWORK SATISFACTORY, PROCEED
o CORRECT ACTION AND PROCEED
o CORRECT W~ c;,LL FOR REINSPECTION BEFORE COVERING
Inspector: (./' y Owner/Contr:
,C;;;:1;[9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
JNSNOTI
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
fIf:.Oh
(Please type or print and si~ at bottom)
ADDRESS
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3 Yellow
File
City
Applicant
PERMIT NO. (8'. (> t;-~- 'c;
1-"/ C .'
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ZONING (office use)
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(N ame)
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(Phone)
(Address)
B(CUILDERN ) .~" '1 ilJ(AII i'A I ," v. f,t
ompany ame L {f, \. ~ -..~\. Lv- - '-1
(Contact Name) A J-<
(Address) ( 1---;)) '7~ f- 4il_Jt- I) 4- d ("\
(Phone) 75.). -.:J. Yc - s s C.W-
(Phone)
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TYPE OF WORK 0 New Construction ODeck OPorch , e-Roofing
OAddition DAlteration o Utility Conne tion
o Mise
ORe-Siding OLower Level Finish
o Fireplace
CODE: OI.R.C. OI.B.C.
Type of ConstnIction:
Occupancy Group:
Division:
A
B
I
E
II
F
I
III
H
2
IV
I
3
V
M
4
A
R
5
B
S U
PROJECT COST IV ALUE $
(excluding land)
I hereby certily that I have hlrnished rntill'matlOn on this application which IS to the best of my knowledge true and correct. I also certlly that I am the owner or authonzed 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 lust cause Furthermore. I hereby agree that the CIty official or a deSIgnee may enter upon the propelty to perform needed inspectIons
X /)/~':-~~---:7~ ~?C:;!(~ L_/C-/jl( 'f:~I~-Ol:
..,.. -=- 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 $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
#
#
I $
I $
I $
I $
I $
I $
I $
I $
I 1$
tNO
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Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
#
#
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
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p, r:'
56 g~,
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13uildlllg OfIicial
Date
ThIS IS to eertlly that the request In the "bove applicatIon and accompanymg documents IS m accordance with the City Zoning Ordinance and may proceed as requested TIllS document
when signed by the City Planner constlIutes a temporary Certificate of Zonrng compliance and allows constructIon to commence, Before occupancy, a Certificate of Occupancy must be
issued
Planning Director
Date
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions. if any