HomeMy WebLinkAboutBuilding 08-0623
CITY OF PRIOR LAKE
INSPECT/ON NOTICE
ADDRESS t5'l~
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
~NSULATION
INAL
o SITE INSPECTION
DATE TIME
SCHEDULED ~I 0 ~
I~\uJ2 '0'}~
CONTR.
PERMIT NO.
o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
(J ~ O;;;;r;AL
"~t - V
COMMENTS:
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v
. Pr--'~
o Exfu'RAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GASLlNE AIR TST
o
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~WORK SATISFACTORY, PROCEED
o CORRECTfjON AND PROCEED
o CORRECT, 0 , CALL FOR REINSPECTION BEFORE COVERING
Inspector: Owner/Contr:
CALL- ~o FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
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~i~e ~:~ I PERMIT NO. OCl. 0/ ? -:; i
3. Yellow Applicant 0 lP t.- ...2.-.J
(Please type or print and sip at bottom)
. ADDRESS /578q J:Slt9JI)::tvieu; KOM ZONING (office use)
Pr \ Oy- LbJt" WW. "Y53/d.
LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
OWNER
(Name) =-.Johlr\ UWWlA.lrfJJX
(Address) 15"1CC! -r\Ia1tlot'\Jle.w~ f}-iOY~ mN. '7S37d-.
_ (Phone)
BUILDER
(Company Name) 1AS Ctit~.
(Contact Name) --rY10VVtJ-S lAddJM.S
(Address) 1511,,~ ~ft'1MVYYTrl. ~se.h10WA-.t. MtJ. ~'5fk8
PID
(Phone) 105/-J./J3-D38g
(Phone) jo/J-k> 85- J:7 ~Lf
TYPE OF WORK 0 New Construction ODeck OPorch MRe-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAddition DAlteration DUtility Conne6icin
CODE: OJ.R.C. OI.B.C.
Type of Construction:
Occupancy Group: A B
Division:
o Misc:
J
E
II
F
1
fiIV
H J
2 3
V A B
M R S U
4 5
PROJECT COST IV ALUE $ 31 OW. 00 J 3ds.lv...o.Yt;
i
(excluding land)
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 y.vyC"j 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 pennit for just cause. Furthermore, I hereby agree that the city official or a designee may enter upon the property to perform needed inspections.
x~LLi'/~c..k_C~ L f3:C,t~~054-1d?50 8h31o~
. Signature 00 Contractor's License No. Date
I Permit Valuation
I Permit Fee
Plan Check Fee
State Surcharge
Penalty
I Plumbing Permit Fee
I Mechanical Permit Fee
I Sewer & Water Permit Fee
I Gas Fireplace Permit Fee
I
I $
P
P
I $
I $
j$
I $
j$
. Park Support Fee
SAC
I Water Meter Size 5/8"; I";
Pressure Reducer
Sewer/Water Connection Fee
Water Tower Fee
I Builder's Deposit
Other
TOTAL DUE
This Application Becomes Your Building Permit When Approved
..... .
-jv-/
~ . IS-.Of
I Paid
I Date
Building Official
Date
# I $
# 1$
! $
1$
# I $
# I $
I $
Il I $ b<.,.
j$
J /
fiP' No ,g,~b
'1:-
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 Gty Planner constitutes a 'WU}M4l)' Certificate of Zoning compliance and allows construction to commence. Before occupancy, a Certificate of Occupancy must be
issued.
Plannin~ Director
Date
24 bour notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street S.E., Prior Lake, Minnesota 55372
Special Conditions, if any