HomeMy WebLinkAboutBuilding 04-0005
ADDRESS JLI ~ 7 c;
lfiAT1
SCHEDULE~ q ',5- It?
7)f);.J Q t-
TIME
CITY OF PRIOR LAKE
INSPECTION NOTICE
OWNER
CONTR.
PHONE NO.
PERMIT NO.
t.j-- 0 CO )"
o FOOTING 0 PLUMBING RI
o FOUNDATION 0 MECH RI
o FRAMING 0 WATER HOOKUP
o INSULATION 0 SEWER HOOKUP
jZf'FINAL 0 PLUMBING FINAL
o SITE INSPECTIO~~ 0 MECH!I~ . l
COMMENTS: PO~ -" 'v"'-1... <vI\
o EX/GRAD/FILLING
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
('
( .
\.....
/!\ ~
( / /) '}.
'cc;-L ~ f~ lfJ
pORK SATISFACTORY, PROCEED
o CORRE7i3T ION AND PROCEED
o CORRE W . LL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr: .
~ALL 447-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE,
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETYl
INSNOTI
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
/. (P.04-
(J /, 0578
(Please type or print and sign at bottom)
ADDRESS
/ 4<5"7 q Dt1VC. c:T
1 White File
2. Pink City
3, Yellow Applicant
PERMIT NO.O I/- . 0005
ZONING (office use)
r<-I
LOT
BLOCK
LEGAL DESCRIPTION (office use only)
ADDITION
PID 2-5. 3t,8. 0/ a. 0
~~~~'M;4/ .~:'ttJ'7~'< /)
(Phone) t):;-Z z.3'~ "// zf)
,
(Address)
BUILDER
(Name)
(Contact Name)
(Address)
(Phone)
(Phone)
TYPE OF WORK
o New Construction
OLower Level Finish
ORe-Roofing
ORe-Siding
ODeck
OPorch
OAddition
o Alteration
OUtility Connection
o Fireplace
PROJECT COST IV ALUE (excluding land) $
3,000,ot)
$ 7~-. '75
$
$ 1_.50
$
$ 4-0.0 0
$
$
$ -
This Application Becomes Your Building Permit When Approved
Building Official
Date
o Misc.
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 ns. I am aware tp.at the bUlldmg official can.rtvoke this p~rmit for just cause. Furthermore, I hereby agree that the city official or a deSignee may
enter u e property to arm needed inspections. 'VI't't1 I~.'/'~":;Y;;;"? '- .J U
X v~--" ~ I-;;~t~ "T
Signature Contractor's License No - Date
Park Support Fee # $
SAC # $
Water Meter Size 5/8"; 1"; $
Pressure Reducer $
\ City SAC and WAC # $
I Water Tower Fee # $
I Builder's Deposit $
\ Other a-~U lWn..- $
I TOTAL DUE $
I. U <."I
//7, 2 !::J-
~.? ~ b ~ >
I Permit Valuation
I Permit Fee
I Plan Check Fee
State Surcharge
Penalty
I Plumbing Permit Fee
\ Mechanical Permit Fee
\ Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
I Paid
I Date
II?- ,~5 '
1-- & - pt
Receipt No.
Bv r;
cf
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.
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
Planning Director
PRIOR LAKE
INSPECTION RECORD
14-~ f)()1I6
DEPARTMENT OF
BUILDING AND INSPECTION
SITE ADDRESS
NATURE OF WORK
USE OF BUILDING -
PERMIT NO. ~~ 7I.TEISSUED I. ".0'1-.
CONTRACTOR PHONE~~
NOTE: THIS IS NOT A PERMIT FOR ANY OF THE INSPECTIONS BELlfW
THE PERMIT IS BY SEPARATE DOCUMENT
~
, "
I j
I ~
PLACE NO CONCRETE UNTIL ABOVE HAS BEEN SIGNED
ROUGH - INS
INSPECTOR
DATE
~.
FRAMING
INSULATION
ELECTRICAL
PLUMBINC:
HEATING \11 required)
.
j/ /-)
/ I
/13Io~
I .J
'~ ~ r
J
COVER NO WORK UNTIL ABOVE HAS BEEN SIGNED
I I
FINALS
/ f
r; /~~ 2
I I
-
BUILDING
ELECTRICAL
. PLUMBING
HEATING
DO NOT OCCUpy' UNTIL ABOVE HAS BEEN SIGNED
NOTICE
This card must be posted near an electrical service cabinet prior to rough-in inspections
and maintained until all inspections have been approved. On buildings and additions
where no service cabinet is available, card shall be placed near main entrance.
flj5 i
J
FOR ALL INSPECTIONS (952) 447-9850