HomeMy WebLinkAboutBLDG 08-0672
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
ll~<..l~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
&~NSULATIQ~ n
,-o-r-INAL Vt}~~
o SITE INSPECTION
COMMENTS:
- -
( , \ ~.. r"\ rl--./ /VI
\J '
DATE TIME
SCHEDULED IJ cr/~ &0
f J
ScJiA<;..() 1- ~ r
CONTR.
PERMIT NO.
9 - ~(2
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o MECH FINAL
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
~ ~
l.-... r"\
'I - "'--L,.I
v
rORK SA TISr.1:FRY, PROCEED
o CORRECT AC , .ND PROCEED
R .1ALL FOR REINSPECTION BEFORE COVERING
Inspector: /.;t T I \ Owner/Contr:
---
50 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
C:~~.::"'\.l
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYI
INSNOTI
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
I White
Pink
3 Yellow
File
City
Applicant
PERMIT NO. cZ' "0"] L
(Please type or print and sign at bottom)
\ ADDRESS
/\ 11J c..J-g cSUVls.d Tt/ S W
ZONING (office use)
LOT
\ OWNER
/'\ (Name)
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
PID
(Address)
Rolo~
~a'm e..
BUILDER
(Company Name)
(Contact Name)
(Address)
~ I'd
(Phone) CJr -:J.. 4 L.J 7
~sSD
(Phone)
(Phone)
TYPE OF WORK 0 New Construction ODeck OPorch ORe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
/ DAddition DAlteration DUtility ConnectIOn
CODE: [~h.R.C. DI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
o Mise. ~ f>t:&.J tiE 9c...Jt-~C~
I II III IV V A B PROJECT COST IV ALUE $
E F H I M R S U
1 2 3 4 5 (excluding land)
I hCleby CCItIfy that I have hlrmshed mtormatIOn on thls apphcatlOn Wh1Ch 15 to the best of my knowledge tIue and corrcct I also CCltify that I am thc ownel 01 authonzed agent tor the
\. abllve-menl1oned pJOpClty and that all con cl10n WIll conform to all eXlstmg statc and local laws and will plOceed m acclJldance wIth submltted plans I am awale that the blllldmg
~ olflclal can revoke thiS pelmJt for Just cause F HhelmOle, I heleby agree at the CIty offiCIal or a deSIgnee may enter upon the plOpelty to pel form needed mspectlllfiS
. X >> -~nature Contractor's LICense No Date
v
TI", A":1\". \. ~ P,nul' Whf APprof'
~) ('-'''-- __ 'l: I z / / Ct:;,
Buildll,g ~ial I]ate .,
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
2 ~<.Jc; _'
Park Support Fee
SAC
$
$
$
$
$
$
$
$
$
7. <::..-: --
(4-1<;
#
#
$
$
$
$
$
$
$
$
\ - Z.s-
Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
#
#
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
Paid
Date
-lv I
b l-z -, (() Z5
I j
Receipt No. . "'")'-.=-( ') '1
By (~l IA-
ThIS IS to certIfy that the request m the above applicatIOn and accompanymg documents IS m 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 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