HomeMy WebLinkAboutBuilding 08-0665
SCHED DATE
~r~ 16/{oC
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
Sfe3LJ
OWNER
CONTR.
PHONE NO.
PERMIT NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
~INAL
o SITE INSPECTION
n(~~~
11\
~
^ /
4-v~
...
TIME
6B -0 (".If
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
o
. IJ I'J
1/ i. 1.44
" V'
)( WORK SATISFACTORY. PROCEED
~ CORRECT ACTION AND PROCEED
o CORRE"i'!' CALL FOR REINSPECTION BEFORE COVERING
Inspector: tf-f Owner/Cantr: .
CALL 447-9850 FOR THE.NEXT INSPECTION 24 HOURS IN ADVANCE.
. ,
IIc&1A
1/
CODE REQUIREMENTS ARE)FOR YOUR PERSONAL HEALTH .{ SAFETY!
LNSNOTI
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
B. z'-. () ~
I White
Pink
Yellow
File
City
Applicant
\ PERMIT NO. 08 . 0 ft;(p5 !
(Please type or ~rint and sign at bottom)
ADDRESS
5b~c.{ C~i~ad"'u)Oocl ~~ \.
ZONING (omce use)
LEGAL DESCRIPTION (office use only)
I
LOT BLOCK ADDITION
PID
~'::~R ~UEr'\ ,,~_,,-,~t>C~S
(Phone) '75:+ - Lj C] h - l':::'" c; G/-;)
(Address)
BUILDER
(Company Name)
(Contact Name)
(Address)
(Phone)
(Phone)
I
TYPE OF WORK 0 New Construction ODeck OPorch X1'Re-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition OAlteration OUtility Con~
I hereby certify that I have fmmshed mfnrmation on this appficallon which is to the best of my knowledge true and correct. 1 also certlty that I am the owner or authorIzed agent fnr the
above-menlloned property and that all Cllnstrucllon Will conform to all eXlstmg state and local laws and will proceed m accordance with submitted plans. I am aware that the buildmg
:'"'' \$;:::0' \' ~.~" '.~ "" ,Oe "" 0,"".'" , ,,,'.",, =, '"'" ">'" ", ~",m, w ,,",orm "~: :r~":'61-
Signature Contractor's License No. Date
CODE: OI.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
Permit Valuation
Permit Fee
Plan Check Fee
State Surcharge
Penalty
Plumbing Permit Fee
Mechanical Permit Fee
Sewer & Water Permit Fee
Gas Fireplace Permit Fee
o Misc.
I
E
II
F
I
III IV V
HIM
2 3 4
A
R
5
B
S
u
PROJECT COST IV ALUE
(excluding land)
$
$
$
$
$
$
$
$
$
Park Support Fee
SAC
# $
# $
$
$
# $
# $
$
$
$ 7(P -
/J
j~.t No _5l, 7$4-
.
Water Meter Size 5/8"; 1";
Pressure Reducer
SewerlWater Connection Fee
Water Tower Fee
Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid
Date
-!~ - -
~-'1/" - Of
13ll'.l~_'.ng Ofticial
Dale
ThiS IS to cerllty that the request in the above applicallon and accompanymg documents is m accordance with the City Zoning Ordinance and may proceed as requested. ThiS document
when signed by the City Planner wnslltutes a temporary Certifrcate of Zonmg Cllmpfiance and allows Cllnstrucllon to commence. Before occupancy, a Cerllflcate of Occupancy must be
issued
Special Conditions, if any
Planning Director
Dale
24 hour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372