HomeMy WebLinkAboutBuilding 08-0785
CITY OF PRIOR LAKE
INSPECTION NOTICE
ADDRESS
L( tlSO
OWNER
PHONE NO.
o FOOTING
o FOUNDATION
o FRAMING
o INSULATION
:;4. FINAL
o SITE INSPECTION
COMMENTS:
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DATE TIME
SCHEDULED ,off ( c6
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CONTR.
PERMIT NO.
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o PLUMBING RI
o MECH RI
o WATER HOOKUP
o SEWER HOOKUP
o PLUMBING FINAL
o 0 MECH FINAL
K.e. ) Ot.:1 ~
o EXIGRAD/FILLlNG
o COMPLAINT
o FIREPLACE RI
o FIREPLACE FINAL
o GAS LINE AIR TST
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~RK' SATlstACT~RY, P~EED
o CORRECT ACTION AND PROCEED
o COR~T ORK, CALL FOR REINSPECTION BEFORE COVERING
Inspect r: I A Owner/Contr:
CA 7-9850 FOR THE NEXT INSPECTION 24 HOURS IN ADVANCE.
CODE REQUIREMENTS ARE FOR YOUR PERSONAL HEALTH & SAFETY!
lNSNOTl
CITY OF PRIOR LAKE BUILDING PERMIT,
TEMPORARY CERTIFICATE OF ZONING COMPLIANCE
AND UTILITY CONNECTION PERMIT
Date Rec' d
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] White
Pink
3 Yellow
File
City
Applicant
I PERMIT NO. 08,0785'
(Please type or print and sil1:n at bottom)
ADDRESS
ZONING (office use)
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LN'
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LEGAL DESCRIPTION (office use only)
LOT
BLOCK
ADDITION
PID
OWNER
(Name)
Jo hn ~'OJ' (\ h 0 \ A .\-
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Y II S>() (e CI\.0Vt t'Vtc\ n
(Phone)
(Address)
Ln
BUILDER .;) -, \ . C~.\. S ' \
(Company Name) t (t:J(;J::JTI C\, ( (V\ <- () un
(ContactName) 00~_~' Ab~0S-Sc:-\"f""'-
(Address) Lj(.,S? Nlz,o \ 5 ~
by\. )
~\.~~y; V\
(1/1 tV'
(Phone)
(Phone)
5~/7c-
TYPE OF WORK 0 New Construction ODeck OPorch ~-Roofing ORe-Siding OLower Level Finish 0 Fireplace
OAdditlOn OAlteration OUtility Connection
CODE: DI.R.C. DI.B.c.
Type of Construction:
Occupancy Group: A B
Division:
o Misc.
I
E
II
F
I
III IV V
HIM
234
A
R
5
B
S U
PROJECT COST /V ALUE $
(exduding 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 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
~licial can :voke this permit for Just ca~ Furthermore, I hereby agree that the City OffiC;:~ ~s~~~ ~~ ;er upon the propeny to perform needed q};~~ Ir") y
Signature Co~tractor's License No ~ / Date t ~
Permit Valuation
Permit Fee $ 70
Plan Check Fee $
State Surcharge $
Penalty $
Plumbing Permit Fee $
Mechanical Permit Fee $
Sewer & Water Permit Fee $
Gas Fireplace Permit Fee $
Park Support Fee
SAC
#
#
Sewer/Water Connection Fee
Water Tower Fee
Builder's Deposit
Other
#
#
$
$
$
$
$
$
$
$
$
7b
Water Meter Size 5/8"; 1";
Pressure Reducer
TOTAL DUE
This Application Becomes Your Building Permit When Approved
Paid 7(, - /
Date "'th. (1/
rJ
Re~ipt No. ~ 9'1/
~~ -,
o
Buildlllg Official
Date
ThiS IS to certify that the request in the above applicatlOn 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 constructlOn to commence. Before occupancy, a Certificate "f Occupancy must be
issued
Planning Director
Date
24 hOllr notice for all inspections (952) 447-9850, fax (952) 447-4245
4646 Dakota Street Prior Lake, MN 55372
Special Conditions, if any